Neo-Adjuvant Chemo - It's Working!

I am having 6 FEC treatments before surgery. The reason was my tumour was too big to do just a lumpectomy. It grew from me knowing/feeling nothing to 5cm in 6 weeks to dx.

I was prescribed chemo first to try to shrink the tumour to try to preserve the total breast.
I am delighted to say that I have had ultrasound this week after 3 chemos and the tumour has shrunk by 75%. Both the radiologist and my onc said it was better than could have been expected.

I have seen this tumour like a school room bully - it grew so fast but as soon as I have put up a defence it has run off like a wuss.

I still have to have surgery and rads and herceptin but I feel I am beginning to win the first battle in the war
Hope everyone else can have good news too

Sharon x

Interesting that you see your tumour as a school bully. Being a gardener I visualise mine as a type of bindweed, and the chemo as a sort of systemic weedkiller …

Stockbeck

Hi Sharon

Great news that your tumour is shrinking. I have just come out of hospital after having my lumpectomy, my tumour had completely disappeared. I went down for an ultrasound and mammogram just before my surgery and they couldn’t find any evidence of where it had been, luckily my consultant had marked where the tumour was. (well I hope that she got it right i will find out when i get the results next Wednesday!)

So make sure that your consultant marks where the tumour is before it disappears completely! i have heard stories of people having to have a mastectomy because the original tumour couldn’t be located.I think they put little pins in, I had a mole next to mine, so it could be found - I never thought being moley was an advantage before!

Take care keep enduring the chemo - at least you know it is doing something positive!

Nicky

Hi All
I was worried about the neo-adjuvant bit - but now I can see my tumour is on the run its not too bad. I now have a complete clinical response (think this means they cant feel it) from 8 cm. Wont know until mamogram in few weeks just how its shrunk. 1 more chemo then its out with it. Cant wait to get rid of it. The chemo really does work and if its having this effect on the tumour it must have nuked anything else out there. Unfortunately mine wasnt marked - so we`ll see what the mammogram shows.
TFN
Jane

Luckily mine was marked before chemo 1 and my onc said yesterday it should mean I only have to have a lumpectomy

Sharonx

Hi Jane

I really hope they can find something on your mammo/scan! They couldn’t for my tumour and I lost the chance of Lumpectomy and had no choice but the Mastectomy.

Lynn

I’m worried now about the disappearance of my tumour, which wasn’t marked.

I don’t understand this. As they have the original mammogram and ultrasound readings that show the tumour’s location precisely, why is marking necessary? If it is, why don’t they do it to everyone?

The whole point of neo-adjuvant chemo is to avoid the need for a mastectomy if at all possible, so why would they put this at risk by failing to mark shrinking lumps? I’m seeing the surgeon on Thursday, half way through my neo-adj chemo and will raise this then. If a failure to mark lumps results in unnecessary mastectomies, it seems extraordinarily careless and inefficient!

Stockbeck

That was what I was told by surgeon and Onc when I commenced neo-adj last year, yet I’m sat here 11 months later one boob less. There seem to be more and more ladies going through neo-adj and in the whole they appear to get away with the WLE, I find it heartbreaking to read about (that’s just a bit of self pity I know and I realise there are so many ladies much worse off than I am/have been).

So much for "the whole point of neo-adj… "!

Good luck to all of you who do get the op as planned.

Lynn

There are two points to neo adjuvant chemo:

  1. to shrink the lump to up the chances of WLE rather than mastectomy…this is the point often emphasised to patients BUT

  2. the point from ocnologist’s view is to see how effective chemo is, how responsive and aggressive the tumour, and therefore to assess whether a change of chemo might be necessary.

My neo adjuveant chemo didn’t work…I had AC and it seemed to shrink the tumour during the first three cycles but then grew again and I still had active cancer at mastectomy. However this did mean I got a change of chemo after matscetomy…to taxotere…I was then in remission for 2.5 years before current regional recurrence.

I agree tumour needs marking, but remember that the second point of neo adjuvant chemo is perhaps the most important.

Jane

Hi All
It has always been made clear to me that the rmain eason for my neoadjuvant chemotherapy was along the lines of your point 2 (Jane RA) and to prevent any spread ASAP (as had obvious lymph node involvement) and that any reduction to allow a WLE would be a bonus (tumour is multi-focal so a mastectomy was 1st choice), its only now that the response has been so good that a WLE is in the picture. I am psyched up for a mastectomy, as best as I can be, and darent hope for a WLE.

Reading your message has also enlightened me a little as to why some woman have chemo after tumour is taken out, despite having had ne-adjuvant therapy.

I am pleased with my response - but do feel for thos women who might not have the same response.

My oncologist has asured me I wont need a 2nd round of chemo but am still a bit wary of nasty surprises.

JaneRA - how are they dealing with your re-currence ?

Have mammogram scheduled for 1st Aug and consultant appointment on 6th to discuss surgery etc. Will see then whether marking is an issue. To be in the sittuation where it is would be nice in a way as means tumour response was way beyond any expectations.

TFN
Jane

Hi
Good news Sharon - that’s great. I am starting my FEC chemo this friday. My lump is 6cm and growing quite fast as I can now see it when I look down at my boobs! Anyway they wanted to shrink mine before surgery so I hope I have the same success as you. I will def have to have a mastectomy due to size/trip negative/location.
Speak to you all soon
Ali
x

Hi Jane68

I am having a combination of xeloda and navelbine for my regional recurrence in chest wall and supraclavicular lymoh nodes. Surgery not possible nor raidotherapy as I’ve had it in that area before. Also as I’m triple negative hormonals and herceptin not options.

You are right that the most important reason for neo adjuvant chemo is to try to check spread…if you get to have a WLE rather than matscetomy thats a bonus.

Jane

Please don’t think that I am ignorant to point 2 Jane, I am a staff nurse and have worked in both Surgery and Oncology so yes I do understand point 2! But, that does not make me feel any better inside or outside - I am thankful that I have no spread and that chemo worked 110% and that I am now NED.

I am not chuffed that so many ‘get away with it’ and do get that shrinkage that point 1 relates to for many of us and enable them to have the WLW rather than Mastectomy, but hey ho good for them :slight_smile: Some of us are led to believe by their consultants (maybe I was foolish to listen and should have known better, I’ve worked for the NHS for 18 years so I know the system well) that the main reason for chemo in their instance is the size & location of tumour, in my instance sitting behind the nipple and large enough to say that if it did not work Mastectomy would be the only option.

So maybe you can imagine what it feels like when you are told it’s totally gone 110%, yippee, yay… wasn’t that what they said they hoped would happen… yet then it turns into your (maybe not in your scenario, but thats not my business) worst nightmare (and for me it is that - it’s a personal thing isn’t it) :frowning: Thats what really gripes me, ok!

Lynn