Hi.
I have had the results of my biopsy back and I have breast cancer. It is HER2+ve, grade 3 and somwhere between stage 2 and 3 with a 6cm tumour and at least one lymph node involved. I still have to get the results of other scans back to check for distant secondary sites but my onc thinks it’s unlikely to have spread.
He is suggesting that I have chemo/herceptin treatment FIRST rather than operating. This is for 2 basic reasons.
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If they operate now, they will have to remove my whole breast due to its size and position - hopefully having the chemo first will promote tumour shrinkage, thus allowing them to perform a lumpectomy at a later stage and save my breast.
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As they can monitor the results of the various chemo/herceptin combinations by watching what effect it has on the tumour, they will know when it’s working. I have lymph node involvement, so my cancer must be considered systemic. So, if it’s shrinking the tumour efficiently, then it must be hitting any other micro metastasies that they cannot pick up or any other random systemic cancer cells in my lymphatic system or bloodstream.
…That’s the theory, but is it creating any extra risks leaving the tumour in situ? Has anybody else had chemo treatment first before the op? Any suggestions?
Very scared - don’t like to be left to make this decision myself.
Hx
Dear Heartdrive
I am sorry to read of our recent diagnosis. Breast Cancer Care have published a Resource Pack, it has been designed for anyone newly diagnosed with information to help you better understand your diagnosis, test results and various treatments, it is available via the following link or by contacting the helpline:
breastcancercare.org.uk//content.php?page_id=7514
You may find our helpline useful to call to talk through the concerns you have about surgery and treatment options, they can talk to you about our other support services too and also offer support, information and a ‘listening ear’. The number to call is 0808 800 6000 Monday - Friday, 9am - 5pm, Saturday, 9am - 2pm. I hope you find this helpful.
Best wishes
Lucy
Hi, sorry to hear of your dilemma, nothing is ever easy when faced with BC.
However, I know a woman who was in pretty much the same position as you and she had the chemo and some herceptin first before surgery. Her lump shrank successfully and she has now got to the stage where she only has about 3 Herceptin treatments to go. Aside of menopause problems she is feeling well. Her mother also had BC a few years ago so there was a genetic link.
Whilst the decisions we face are really hard I am sure your oncology team will have weighed up all the options and they will have come up with the best solution. I am also Her2+ and in my own case the cancer was not detected by any of the tests as it was hidden by a fibroid; I had already been told I was fine, then 4 weeks later I had aggressive cancer. I then had a further surgery to remove the nodes and it was in 1 out of 22 - the cancer was so aggressive I had convinced myself it would be in all of them, so only 1 was a relief. That was back in Oct 2006 - I’ve now done all of the treatment and finished Herceptin 4 weeks ago. I should have had my last onc appointment on Tuesday, but they are going to see me for one further follow up as I have been prescribed something for menopause and have been referred for counselling to clear up any issues I have. I now plan to move on with things as I feel very, very well.
I think the best advice is to listen to your medical team, but don’t be afraid to ask questions - I used to turn up with a sheet of A4 and the oncs told me this week they thought I was a great communicator as I always knew what to ask them lol!
Take care and stay well, try not to get too stressed - I swear by meditation cds and incense sticks.
Dear Heartdrive
I was diagnosed this January and chose the chemo before surgery for eaxactly the reasons your doctor gave you. Although for me the shrinkage of the tumor will not mean saving of the breast ( I am a BRCA1 gene carier and will have to have bilateral mastectomy -healthy boob and all-with immediate reconstruction, as otherwise my chances of it coming back will be too high), but it is really good to see that the chemo is working (my tumor shrank by 75% ) then you know that you are not suffering all the horrible side -effects for nothing. I don’t think once the tumor will start shrinking as a result of chemo it will be dangerous any more.
When I was first diagnosed I was so keen on starting ‘‘killing’’ the cancer that having chemo first was although the quickest action. If I had the surgery first, I would have to wait for the surgery and then wait to heal before starting chemo, while any escaped cancer cells would have had a chance to settle and start growing in my system, so I really hope that the chemo killed them everywhere, not just in the breast.
Wishing you best of luck with your decision and treatment. Stay positive -there is a long journey ahead and it’s hard, but it is do-able, as you will find out from reading many comments on this site.
Take care,
Irina.
Hi Heartdrive
I was diagnosed with breast cancer in september 2006, tumour 7.5cm 1 node affected and triple negative, grade 3. My surgeon was very supportive and also gave me the choice of chemo first or mastectomy, auxillary node clearance then chemo. She also explained that due to the size and position of my tumour if I had a mastectomy first I would need quite an extensive skin graft. I was also given an appointment with the oncologist to discuss my options who suggested that with chemo first I could have breast conserving surgery.
I joined the neo-tango trial and had 6 months of chemo first, the chemo worked fantastically. I had a marker put into the tumour halfway through the chemo, which is vital if your tumour is shrinking and you want breast conserving surgery as without the marker they do not know where the tumour was orignally sited and you end up having the whole breast removed unecessarily.
After six months of chemo my tumour had disappeared and I had full auxillary node clearance and wide local excision and when I got the results back from the surgery there was no evidence of the tumour left which was fantastic. I then had six weeks of radiotherapy. I am now back at work and living my life with no evidence of cancer anywhere.
The journey was long and difficult but the end result was worth it, from my personal experience I would recomend the chemo first but that is only my opinon. I am sure you will get lots of replies with different experiences, but keep posting on here as it is a lifesaver to draw upon other peoples experiences in the same situation as you.
I am sure you will make the decision that is right for you.
Take care
Rizzo
Hi,
I appear to have a similar dx to you. I have been told I have 4cm tumour and I am HER+ my ONC has never mentioned grades or stages, I think that can only be confirmed after surgery.
I was never given an option, I almost immediately started chemo, I have just had my 2nd A.C. I will have 4 or 6 before surgery. I think this is more common in larger tumours. I wiil then have either more chemo or Herceptin or both. After only 4 weeks I can already see an improvement.
Whilst at the hospital waiting for dx I met an old friend who told me she had had a 3cm tumour and after downsizing they couldn`t even find the tumour at first !! she managed to have a lumpectomy followed by chemo and after 5 years all tests are clear.
I am trying so hard to live life as normal… Chemo is very doable…for me it hasn`t affected my daily life at all, I still golf 3 times a week and have my two small grandchildren regularly every week.
Go out for regular lunches and dinners. We have even had a brand new kitchen put in over the past two weeks ( what a mess!!) but we have coped really well…
Of course there are scary things like hair loss etc (I lost mine after 16 days ) But you know Its really not half as bad as you anticipate, with the help of the ladies here we have had a really good laugh!! I have also bought a selection of different coloured wigs far better than my own hair! Also bought lots of new make up to go with them!
I refuse to let anything bring me down…when I am tired I go for a long walk and it works wonders. From day one I vowed to take just one day at a time, not to look too far ahead( far too much to take in at once!) I have also had wonderful support from friends and family as I`m sure you will and it helps so much.
Good luck in making your decision, I hope this helps a little,
Take care,
Janx
Hi Heartdrive,
Like those replying to you above, I too had chemo in order to shrink the lump. For me that was 18 years ago and things have changed. I wasn’t offered a choice and the chemo was very successful in totally eradicating the lump. So I went on to have radiotherapy and no surgery. Today I think surgery is invariably done. One question I would ask your oncologist - Will a guidewire be put in, should the tumour reduce so much it makes it difficult to define the area that should be removed? I don’t know how common this practice is. I think if they find the particular chemo is not reducing the lump they may well go on to surgery before completing the chemo, and then change chemo afterwards. The main reason for going for chemo first I think is to reduce the lump, making surgery safer and possibly less invasive, but the advantage is to see if that particular chemo works for you. Good luck.
Dawn
dear heartdrive.
I have just registered with this website in the hope of finding someone out there with the same diagnosis and treatment plan as me, and you are it! I was diagnosed last week with a grade 3 lump, size 3-4 cm. I have been recommended to have chemo first to reduce it and then operate later in year after all sessions and if all works to plan. Then have chemo again and radiotherapy. The reasons for chemo first were the same as you were given, and after speaking at length with the doctors, I agreed as believed this to be the best route. Mentally I feel I would cope better with this all if I could see the lump reducing. My first reaction was to get rid of it, even if it meant removing the breast. I am terrified at what lays ahead. I will be starting chemo within the next 2 weeks, just waiting for the dreaded letter to fall through the box!
Its been a very upsetting time so I know how you feel.
I wish you luck and will be watching your link to see how you go.
Deb
I was dx 1 year ago today - 5cm, grade 3, HER2+++ and weakly E+ & Pr+.
I had 6x FEC before lumpectomy. If I would have had surgery first I would have needed a mastectomy. THe chemo did its stuff and reduced the tumour by 75% so I had the lumpectomy and total axilliary clearance. I had 23 rads and then Herceptin. I’ve now had 8 of 16 Herceptin
I had my first annual check up today - mammogram etc. It was all clear. My right boob (the affected one) is (with the help of oedema fluid) pretty much the size of the left one. I was cut from under around the outside of the breast so the scar is hidden and it is fading quite well.
It worked for me but everyone’s different. Only you can decide for you
But good luck for all your treatment in whatever order
Sharon x
Thank you for all your kind and informative comments - it’s great to hear such positive stories - hope you all stay well. You have given me a boost and I’m certainly heading towards going ahead with the treatment as recommended. Will keep in touch and let you all know how it goes - please do the same if you can. Hx
Hi Heartdrive & Debs66,
I was diagnosed back in Nov07 and was in exactly the same situation. It is a really hard decision isn’t it, I decided right from the ontset that I was going to go with whatever decision my team (surgeon and onc) felt was the best for me!
Saying this I started on chemo before christmas and had 3xFec and 3xtax. The chemo i found went well, i was only sick after the first one, the rest i was just REALLY TIRED like you can’t imagine until you go through it. The losing the hair thing was a big thing for me, i did use the cold cap but this didn’t actually work for me and i lost all my hair by the 4th session. Its weird but you actually get used to it, and i had gr8 fun going to choose wigs. I have a long blonde hair wig and i am not too bothered now about the fact my real hair is growing back 
The chemo didn’t have too much effect on the tumour but it was enough to shrink it my 1cm which meant they could save my skin and nipple and put an implant in, which for me was amazing as i am only 28. Now 2wks after surgery i am so glad i did it this way, my next step is treating the secondary cancer i have in the sternem through rads.
I have only recently joined this site, and wished i had done at the stage you girls have, but I couldn’t quite get my head around everything let alone read others stories…
wish you both luck, and if you have any questions ask!!
Lisa
Hi Lisa. thanks for your comments. I heard today I start chemo next wednesday. Dreading it. I feel it is helping a great deal being able to share this all with the people on this site. Have a long haul ahead of me, but will get strenght from this and know it will keep me busy writing to you all, and hopefully make the time pass easier.
Debbie