Question on pathology results when surgery after chemo (Neoadjuvant)

Hi everyone

I was diagnosed back in August 2015 with grade 2 IDC, ER+. My surgeon recommended chemo first, to treat the whole body, as I’m considered young (41). I finished FEC-T on 13th Jan this year and had wide local excision and full clearance last Friday. My questions, if anyone can help, is that the majority of people have the surgery first, pathology report then onto chemo to mop up any stray cells lurking anywhere. I’m so worried that my pathology report will come back really bad and with me already having had the chemo, what then?? I do have radiotherapy and hormone treatment to come but worry that they may suggest more chemo? Can anyone share their experience on pathology results after neoadjuvant chemo? I’m just getting myself so fretful about my results. Thank you.

Hi Bonnie, I have come across quite a few ladies on here who have had/are having chemo first, although I’m not one. My understanding is that chemotherapy would kill off any stray cancer cells lurking around plus shrinking the tumour meaning less to remove. So I’d say you should be confident that it’s done its job in the same way as it would have after surgery. The radiotherapy will then zap a specific area to make doubly sure. Maybe it’s your surgeon or oncologist’s preference to have it done that way? They didn’t ha e to wait for you to heal before starting chemo.
I’m sure others will be along who have had it your way round to give you their experiences too, but as I know how stressful waiting for results is, I thought I’d try and help put your mind at ease a little.
Hope all goes well, take care xxx


i was diagnosed in August 2015. I started chemo on 5th sept, 6 cycles of fec-t. I finished on 17th Dec and had a mx and full node clearance on 22nd Jan.  My pathology results were very good and cancer had responded to chem and the tumour had shrunk and they were confident they had got it all.I know it’s worrying but try to stay positive. X

I am in exactly the same position as you. My op was Thursday 25th and have to wait two weeks for results. How do you feel generaly. My drain leaked. Had to come out and now my boob has swollen up!! Im guessing its seroma. I had chemo first as grade 3, aggressive and growing fast and all my other organs were clear. I know exactly how you feel. Let me know how it goes. Dilys

Hi Dilys, about your seroma build up - I started a thread under surgery that you might find useful if it starts to bug you. We’ve all had different experiences in how our consultants have decided to deal with it, some have had theirs drain, my consultant hasn’t wanted to because I’m going through chemo. The main thing is to keep an eye on it for infection (hot and/or red) and get advice ASAP if that happens.
Good luck for your results - as you know waiting is by far the worst (she says sat here in chemo fog!) and whatever they say - this forum is the best place to keep supporting you and hopefully celebrate with you :slight_smile:
All the very best to you too Bonnie

Hi Bonnie.  BCC have a publication to help interpret your histopathology report.  You can download it as a pdf here


I requested a copy of my report (had to go through the bureacracy of access to patient records which is a pain, but some hospital trusts will just give them to you).  I found it fairly easy to understand and was able to speak to my CNS about any terms I didn’t understand.  Seeing and reading the report myself made it easier to work out which questions to ask at follow up appts.  I also find that the medics often wait for you to ask questions which sort of assumes you have all the info you need to know which questions to ask!!  Brings to mind Donald Rumsfeldt’s (sp?) ‘known knowns, known unknowns and unknown unknowns’ comment and about as helpful!