does everyone have the op

Does the lump have to be removed from the breast can the cancer not be killed off without the op?

Hi Jinpip

Usually the lump is removed by surgery as there is no guarantee that by having chemo all the cancer can be killed off especially if the lump is big and has really taken a hold. Radiotherapy also does a similar job of killing off what’s left but is for more localised treatment. You haven’t given any details about the type of lump you have, what grade it is etc and whether you’ve had any tests such as a CT scan, bone scan, blood tests etc.


hi ruby1. Mines a grade 3 cancer was 3 1/2 cm but have had EC chemo x2 which has taken a couple of millimeters off it . Am changing to taxotere on thursday. But have met people in the past who didnt need an op and was wondering why.

Hi Jinpip

I can’t pretend I know why some people have surgery and others don’t but from what I’ve seen I believe it’s because some people’s lumps do completely disappear - not sure whether it’s because they have a particular type of BC e.g. mine is invasive ductal carcinoma, grade 3 like yours and was 4cm so again similar to you and others have inflammatory breast cancer where I don’t think there is an actual lump as such and there are also others.

I had 3 lots of FEC chemo and 3 lots of Taxotere. Taxotere is said to be like domestos - kills all known germs dead so it sounds like a good thing you’re being switched to that. All chemos works differently for different people though. My lump went to 7mm. Some people also have calcification (there are different types some which are pre-cancerous and others which are just calcification and not dangerous) and the doctors have to determine whether it’s pre-cancerous or not. I had lots of pre-cancerous calcification which had to be removed so ended up having a mastectomy. That type of calcification is not killed off by the chemo as it’s pre-cancerous.

Hope this helps a little and like I said obviously I’m not an expert but some of this is from what I’ve read and some is from my own experience.


hi ruby . Can i just ask if your lump had got that small was it really necessary to have full mastectomy, was a lumpectomy not an option?

Hi Jinpip

I was told right from the start it would be a mastectomy and the reason being that I had widespread (8 cm) of pre-cancerous calfication which means that at any point it could become cancerous so would be dangerous not to remove it. A lumpectomy was never an option in my case and some surgeons like to err on the side of caution and carry out a mastectomy anyway because there is always a chance of not getting it all out and some cells escaping. The more clearance you get around the lump the better. Mine had also spread into my lymph nodes and I had 15 removed from my armpit and one had cancer in it.

I’m off to bed now but will log on tomorrow and will get back to you if you want to know anything more.


Thanks ruby1 you have been a great help .

I wanted to join your thread and just try to clarify a few things.
The role and purpose of neo-adjuvant chemotherapy (sometimes called primary chemotherapy) is always a complex one, and is fundamentally about the individual’s circumstances.

When treating breast cancer surgery is often the first type of treatment to be considered.
Broadly speaking neo-adjuvant chemotherapy will be offered to a person when one or more of the following considerations have been taken;
• The tumour is very large which can make surgery more complicated
• The person is pregnant and surgery is not advisable due to the gestation of the baby
• Given with the aim to reduce the surgery required for example from a mastectomy to a lumpectomy
• There is concern that the person may already have metastatic spread, that is secondary breast cancer elsewhere in the body

Frequently following neo-adjuvant chemotherapy a person will have some surgery to the breast, however what this may entail is very individualised.

These are very generalised comments, and you may feel that your story does not fit into these broad terms. For anyone having neo-adjuvant chemotherapy it is important that you fully understand why you are having the treatment, and what you can expect the next stage in your treatment to be.
I would always suggest talking with your breast care nurse about how you are feeling and asking her any questions that occur to you – she really won’t mind, the more you talk and ask, the more support she will be able to give you.

You may also find it useful to read our booklet on chemotherapy which mentions neo-adjuvant chemothrapy

You are of course also welcome to call our free phone helpline on 0808 800 6000, and someone there will be able to talk through what is happening for you.

Clinical Nurse Specialist

I know most of what you hav said here tara but it is nice to get back up to what you are told,from people who hav been there.Also hearing from people who hav not had to hav the full monty gives hope for us vain ones who are still living the dream !
thanks tho