Lobular Invasive Cancer Grade 3 ER+ HER2+ should I have neoadjuvant therapy or surgery first?


I have recently been diagnosed with LIC grade 3, HER2+ ER+. Multi disciplinary team have recommended neoadjuvant therapy (i.e. chemo with Herceptin) FIRST for 6 months, THEN surgery, then radiotherapy, then hormone therapy.

However, the surgeon (who did my consultation and presented me with the news) want to do surgery first. Then 4-6 weeks after have chemo, then radiotherapy, then hormone therapy. The decision is mine! I don’t know which to do. Anyone out there been in this situation / in this situation? 

It’s a lump that I had checked 3 years ago, and 2 years ago - both times with mammogram and Ultrasound - both times said fibrocystic changes etc. this time (2 years later), it’s a grade 3 invasive lobular cancer. Same lump, same size (22mm). Would love to hear about anyone’s experience / treatment / advice with a similar diagnosis.

Hi, first of all, sending a big virtual hug! It’s a hard time emotionally… 

I had grade 3 triple positive breast cancer ( all high grade in all the stainings ) 

On the recommendation of the team looking after me, we did Chemotherapy first (5months ) with targeted therapies , herceptin and Perjeta, then a mastectomy and lymph nodes removed ( my lymph nodes were involved also) 

then we hit it with 3 weeks of radiation therapy… 

now I’m on tamoxifen and my last herceptin is this coming Tuesday! 
 I had a Complete response to the chemotherapy ( no cancer left  at time of surgery) they way they explained doing the chemo first was it gave the team(Drs) more info about how your cancer behaves and what it’s sensitive too… 

I wish you strength and remember to be kind to yourself… X 


I’ve been diagnosed with the same from what I can tell and the same size! I was advised to go with chemo first , then surgery and radiotherapy and hormone therapy. Just about to have my 3rd cycle. We did query why chemo first and was told that the surgery would be less invasive after as the chemo advised would shrink it significantly. It worried me at the time as I’m thinking that it’s still there but it’s completely a personal choice and you should air your concerns with your consultant and oncologist and see how you feel after?