When would chemo and radiotherapy but *not* surgery be the recommended course of treatment?

Hi all,

 

I’m just throwing this out there-I have yet to have my surgery (unilateral mastectomy) and was 100% certain that this was the right option for me (mainly based on surgeon’s recommendation) but had an email from a cousin who in passing mentioned that her colleague had chemo and radio but no surgery (presumably she still has her own breast). Under what circumstances would a woman have chemo and radio but no surgery? I presume you’d have to have a certain type/size of cancer? Mine is spread out-a bit spotted so to speak (not confined to one lump) and relative to my breast size it’s large which is why I’m being recommended mastectomy rather than WLE but at no point was a chemo/radio combo offered instead of surgery-so I’m just curious. I realise you aren’t surgeons but some of you may have more knowledge than me about this and I want to have as much info as possible before I go under the knife. Truthfully, when I learned of my diagnosis it was the thought of having chemo that frightened me more than surgery but now that I know more about the DIEP I am anxious about the surgery (though admittedly the ratio of positive versus negative DIEP experiences on here seems to be 1:4), hence no surprise I’m worried. Thanks to another thread I’ve recently learned of one lovely lady who had a + experience/recovery. 

 

I just want to know more about when chemo and radio would be the recommended treatment over surgery-any thoughts?

xx 

Hi Marla,
It’s just conjecture really, but from what I’ve seen here there could be 2 scenarios - either chemo was needed in the first instance, which melted the tumour to nothing, so radio was given to mop up afterwards or there might have been spread already.
But, hey ho, maybe I’m talking rubbish, perhaps one of the others may be able to advise.
It’s not really possible to compare treatment plans, as our plan is specific to us.
ann x

You’re right Marla, well meaning third party info from those not affected by the situation is not necessarily that reliable?
ann x

Hello Maria,

The only reasons I can think for no surgery but other treatments being given are:

  1. Someone has declined surgery for primary breast cancer for whatever reason. It possibly could be after having chemo or radiation first.

  2. Someone has been diagnosed at stage 4/secondary breast cancer and the primary tumour can not be located.
    or it can be located but it is judged that removal will make the situation worse

As far as I know, research into this situation has shown surgery of the primary tumour in the breast, and axilla if affected, may stimulate further growth of any secondary sites. I think research has also shown no specific overall survival benefits if surgery to the primary tumour occurs.

Treatment, I think, is focussed initially on the secondary site or sites. Systemic treatments such as hormone treatment if applicable, or chemo may make more sense. Radiation may be helpful for some secondary sites as well as surgery. Perhaps after review of responses to treatment at secondary sites, surgery to the primary site may take place.

Anyway, I am just speculating somewhat so not saying the above is fact.

Take care,

Chick ? X