Surgery after chemo

Hi I’m jumping ahead in my treatment, but it’s going round and round my head so thought I’d ask for help. 

I was diagnosed with a 25mm irregular IDC with lymph node involvement, ER and HEP +  My breast is small and so to achieve a good margin, the surgeon reckoned it would have been a difficult lumpectomy if surgery had been done first. Hence his recommendation that I had 8 rounds of chemo where I also will benefit from 2 targeted therapies. Also there is a question of lung nodes found on a CT scan so I do feel that chemo first gives me the best chance of survival. I’m half way through, cycle 4 this afternoon.

My confusion lies over the amount of tissue that will need to be taken when surgery takes place. My understanding is that the only way they know that all the cancer has gone is to remove tissue and test? So surely they will need to take an amount the size of the original tumour? And so how does that make a difference to having surgery before or after? Full lymph node clearance is also still likely. 

I am not averse to having a mastectomy, and would rather opt for that than have to have further surgery if margins are in doubt. 

Sorry for the long list of questions, but has anyone else had a similar experience and doesn’t mind sharing? 

Thank you ladies. Xx

Hi Butterflyfree

sorry that you havent had a response yet.  Hopefully this will bump it up the list for you.

In the meantime you may find it helpful to ask these questions on the Ask Our Nurses area of the Forum or perhaps talk to one of our specialists on our free Helpline? 0808 800 6000.

Best wishes
Digital Community Officer

I am getting chemo before surgery and i asked my onc how they will know they have got it all with clear margins if it shirinks with chemo etc. she explained the tumour will still leave a dead tumour bed/shell and they will take margins around this.
I have not long taken strong pain meds so hope this makes sense. Will read again in the morning.