Hi there. Im having mx, lymphnode clearance and recon on the 20th Jan (absolutely bricking it) I finished chemo at the very end of November. No contact with onc since then and people keep asking me; why mx after chemo? And I cant really answer them. Truth is, its because they recommended it, but it wasn’t to shrink the tumour tho because Id already had a lumpectomy…
Can anyone shed more light on why this might be, or pros/cons of doing things this way.
Hi Tree
Hope you feeling OK, dunno fully about the pros and cons but my story is this…
Original dx in Sept for Paget’s disease of the nipple,treatable with (just?) an excision and radiotherapy but when they did the excision, found invasive lobular cancer and 9/12 lymph nodes involved.
I was then told I had to have a mx but I just fell to bits and couldn’t handle the thought of it. They then said I could have a mx and immediate recon and that the best would be for me to get started on the chemo as I’d have had to have waited a few weeks for the op. So, I’m midway through FEC-T and will finish this before mx and recon then radiotherapy and tamoxifen.
Have to say I’ve found getting proper information very difficult, it feels as it they don’t want to tell us stuff; I’ve had to ask for info every step of the way and in some cases have been given the wrong info which really doesn’t inspire confidence. I did ask the consultant of there was any difference between having mx and recon before or after chemo and he said there was little difference - will ask the onc when I next see her. When I originally asked about the order for me, mx and recon then rads, she told me the radiotherapy can make the recon hard so I asked in that case why not radiotherapy before instead of after and she said it had to be that way around, so I’m none the wiser really. Have to say the chemo nurses have been fab, angels they are!
Good luck with your op - did they say how long recovery time was likely to be?
Hi dont know for sure but perhaps it was their plan to do as you say lumpectomy ,chemo and rads and after youre surgery ( lumpectomy) they sometimes havent got clear margins around the surrounding tissues left and would have to take out a good proportion of breast tissue to achieve this that it is better to have complete mastectomy and then do reconstruction, they may feel to take out more tissue would leave the breast too disfigured.they may have discovered it was a higher grade than 1st thought or bigger lump or more aggressive so have given you chemo first to start treatment sooner .This however doesnt effect the outcome you will have to ask these questions to youre oncologist but i know a few people who have done it this way round and are doing really well so dont panick x
Tree,
I am having chemo up front. I was told that I would still need the mastectomy definitely, as I also have DCIS, which do not respond as well to being destroyed by the chemo. I was told that often it is just a ‘judgement call’ or gut reaction from the onc and surgical team as to which is done first.
The rads have to be done at the end to effectively ‘mop up’ after the op. And as far as recon goes, I was told that implants were often damaged during radiotherapy, hence the delay. Depends on the type of recon you are hoping for.
I’m sorry you have found it so hard to get the info from your team. Hope this helps a bit, it is only what I have been told, but seems to be similar to your situation,
All the best, Tracey