Chemo without lumpectomy?

Hi, I’m new here. I just found out my best friend has been diagnosed with breast cancer, though she’s still due to have further tests (MRI, liver test, lymph node). She doesn’t have any precise details on the type of cancer (unlike me, she’s never been the sort of person who wants to know all the details of her health issues and just lets the doctors do what they do best) but apparently, she’s been told they’re going straight to chemo (once all tests completed) and aren’t doing a lumpectomy first. Is this common? I’ve always believed tumours are first be removed as much as possible before treating with chemo or radiotherapy.

It depends very much on the type and size of the tumour. If the tumour is large it may be necessary to shrink it with chemo before surgery. That’s the case with me, I’m having chemo and my tumour has so far gone from 15cm to 4cm, I will have surgery to remove it once the chemo is complete.

This way of doing things is less common than surgery first but by no means unusual.


HI worriedfriend

I too had chemo first to shrink the lump as it was 4cm at the time and was also in my lymph nodes. If the lump is large, there is a chance of it growing and spreading quickly and if in lymph nodes, they often do chemo first and then surgery.

Ruby x

Thanks for your quick responses. I’ve got so much to learn about BC… and about how to best support my friend without bombarding her with questions about her treatment, that she may not want to be thinking about.

Hi - it is called neoadjuvant chemotherapy (ie before). It is something that I am having and which my oncologist says is becoming more common. It means chemo can start straight away, without recovering from surgery first. The oncologists like it as they are able to see what impact the chemo is having on the lump and other rogue cells - mine went from 6cm to something that could not be felt between treatments 2 and 3.

It often means lesser surgery - lumpectomy instead of mastectomy.

Best wishes - Paula

Hi Worried Friend

It’s been said above. Not uncommon. It is wonderful that you are thinking so much about your friend.

Supporting her? Be the friend you always have been. Don’t push her to talk, and don’t stop her from talking. She will have thoughts that you don’t want her to have, ie death, but they are real worries, and she needs to express them without them being “oh no you’ll be fine.” At the same time, you need to let her know that you’re feeling positive on her behalf, but acknowledge that death is a possibility. It’s a really difficult role for you, but one that I am sure you are already doing.

One of the best things my friend did, and I’ll never forget it, and I have yet to tell her about it (it just hasn’t come up), I lost my hair. One day she saw me with hair. A few days later I had lost so much hair that I’d cut it all down, and I had started to wear my scarves. I dropped in at her work. Her face registered momentary surprise, and I really mean momentary, then she blinked and went “Wow, that is so chic!” She kept up that kind of support the whole way through. I am indebted to her and love her for that.

Worried Friend, just be there, do what you normally both do together, adapt to what she needs, tell her you love her, tell her you are scared. The same goes for you as for her. You need to be able to express your feelings, but, you have to put her first (sorry, it’s just the way it is), and HUG each other. It will do both of you the biggest service, hug, hug, hug. Best of luck.

Hi worried friend,

Hope you don’t mind me adding a few comments as well.

I had chemo first. The reason I was given was that they need to shrink it first, then they will consider surgery. Just before I started chemo, however, they found out that I’ve got bone metz. So, I’m not going to have lumpectomy at all. I’m happy that the decision of doing chemo first have saved me some time and have got me started earlier on the treatment.

Like your friend, I’m the sort of person never want to know all the details of my health issues and just lets the doctors do what they do best. (I don’t even know how big my tumor was. Hope she’s not as bad as me.)

I can echo others comments about being supportive, like you are doing now. I had well intended friends making my life hell just because they think they know a better way of doing things and dealing with things. So, be that supportive friends, ask her what you can do for her. Sometimes, it’s just the little things that really helps: take her to appointments or maybe just a shoulder to cry on.

Hope this helps and it all goes well.


just to add my Auntie had chemo and redio therapies for her BC but NO surgery at all - she was on a trial in Kent. No return and it’s been a few years.


Thank you all so much for your replies. I think the hardest thing for me will be not to bombard her with questions *I* want answers to, but to allow her to just tell me as much as she wants to, as and when she wants to talk it. I can imagine it must get pretty exhausting having the same old conversations with everyone and she may want to just stick it to the back of her mind and be ‘normal’, without constant BC talk. There’s little benefit of *my* knowing the nitty gritty details of her BC/treatment, but there’s plenty to benefit her just from my being there to listen and support… and I’ll learn to bite my tongue whenever the words “If I were you…” start forming in my head.

Lol! You got it! The “if I were you” doesn’t really work anywhere in our lives does it, but really not now. Although… sometimes a friend has to shake her friend up, even if it’s just to say, “actually, don’t take offence, but yes, your bum does look big in that.” :smiley:

Questions you need to ask are relevant. The more you know, the better you can help her, even if you never discuss most of the knowledge you have. Why not Google for support groups in your area and go meet some folk. The Maggie’s Centres are brilliant. And you are welcome here any time for any question you want to ask.