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Chemo before surgery


Re: Chemo before surgery

Hi Wiggy and everyone
I had chemo before surgery and I am very pleased I did. I was diagnosed last Feb with a 7x8cm grade 3 triple negative tumour in my right breast. I had four cycles of FEC and four cycles of docetaxel. By the third round of FEC, my tumour had shrunk so much it could not be felt and I had a marker put in it.
By the time I went in for my surgery (bilateral mastectomy and reconstruction due to family history), the cancer had broke in two pieces - one was less than 1mm, one less than 3mm. This also meant the surgery was more straightforward.
I found chemo before surgery was great psychologically as it meant I could the positive results the chemo was having. It is also good to get the chemo out of the way first as it really is the hardest part.
I feel incredibly lucky that my cancer responded the way it did - I realise it is not the same for everyone.
Good luck and best of luck to everyone xx


Re: Chemo before surgery

Hi Everyone - I am told from may different sources, including my proff, that the USA are way ahead of us in BC care and having investigated the American web sites it seems that chemo before surgery is the norm there where ever it is possible. As I said before, I think I'd rather have chemo first and be able to monitor if it is working and shrinking my tumour. If it doesn't then you know and can change to another drug or have mx. If you have surgery first and then chemo, there is nothing to see that can tell you if chemo is doing its job. It all always seems worse because wheter you're having surgery or chemo first, everything seems to take so long when we are all desperate to be rid of it asap and get back to a normal life. Good luck and hugs to everyone - x


Re: Chemo before surgery

Hi Wiggy & Everyone,

I finished my treatment which included chemo before surgery one month ago.
IDC, Grade 3, approx. 3cm. Had SNB first (nodes clear), then I had 4 x EC, followed by 4 x Docetaxel all over 6 months. Then 15 rads, no boosters.

I would describe the shape of my tumour as a lump with ‘tails’ coming off it.
Fortunately, the chemo resolved the tails entirely, and the size at the end was 1cm, which had downgraded to Grade 2.

They used ultrasounds to check my progress, & inserted a marker clip halfway through the chemo. When it came to surgery (seg. MX), they still had to remove the 3cm area, plus a bit extra for clear margins, but the surgeon used a special technique to give a good look. So far, I am thrilled with the results! So for me the outcome seems to be a good one….I have to say that I did get a bit anxious about the surgery though. It was a long time to wait & wonder what would happen!

Good luck to you, Wiggy & everyone here.
I’m bumping up another thread on this subject from last Sept., there’s more of us about!


P.S. Just wanted to say Hi to:

Lanterna, Sorry to hear about your TAX leftovers…aside from that how’s it going?
I still have a bit of numbness too, but it does seem to be gradually fading!

…& Hi Shell, we’ve met somewhere along the way I think…. Just wanted to wish you all the best. I hope you get your surgery date soon, that it goes well and you have a swift recovery. Have been following your posts on another thread.


Re: Chemo before surgery

Hi Redders,

I don't think treatment has gone too far in the direction of neo-adjuvant therapy. All this is relatively new, as is the diagnosis of triple negative. I think it's good that the oncologists have more weapons in their arsenal of things they can fling at BC.

And you're right, we have more treatment options.

I guess the important thing is that chemo is a whole-body therapy.If the little b*stard's trying to get out, then chemo has a chance of knocking it flat. In my case (trip neg, IDC, grade 3), EC failed to shrink the brute after 4 cycles. Tax did the biz, but I'm left with joint and nerve probs. But that isn't everyone's experience. Shell, my heart goes out to you: take care and keep an eye on your doctors. You, too have treatment options!

The helpline on here is pretty good and worth ringing if you're worried.


Re: Chemo before surgery


I think Shelly gives the absolute dilemma - it's fine to have chemo first IF it works well and does its job. If it doesn't work then it would seem much better to have tumour removed first by surgery. Someone I know had the chemo first which didn't work and ended up having a mastectomy anyway. As the patient you have the final say as to what you want. In "the old days" people always had a mastectomy first then the chemo to mop up any stray cells - perhaps it's gone too far the other way now?


Re: Chemo before surgery

Hi there,

I was dx in Aug 08 with a 4cm tumor, i was told i would have chemo first.

After having tried 3 different types of chemo over 4 months nothing has shrunk my tumor...It is now approx 15cm,the whole of my breast now.....I wish they would of took it out in August but they were sure they could shrink it....

I have inflammatory BC,grade 3 and 3 nodes containing cancer. I am triple negative meaning chemo is my only treatment for this type of cancer,as the chemo has failed my options now is surgery.

I am waiting for a mastectomy date now, should be within the next 10 days,so they tell me. I will also have full node clearance and extensive surgery (skin/muscle taken from my back to help close the wound up) as they will have to take all my breast skin...They cannot guarantee they will get all the cancer out as the tumor is so large...

If i knew now that chemo was going to fail i would of pushed for a mastectomy sooner,we just have to trust the medical profession to take good care of us........../

Thinking of you all, good luck to you all too




Re: Chemo before surgery

Hi Michelle

I'll give a different experience, just for contrast. I was diagnosed on 17th Dec with a 3cm tumour and went in for lumpectomy and node clearance on 22nd Dec. My own point of view was that I'd rather have the horrid thing removed first if possible rather than leave it there while chemo did its work. The results of my op were that the lump (which was slightly bigger than they thought at 35mm) was removed with clear margins and my nodes were clear. I now go into chemo in the next few weeks in the knowledge (touch wood!) that the cancer has gone and that this is just a mopping up exercise against any cells that may have gone astray.

On the other hand my sis in law had extremely successful chemo first to shrink a large tumour - it worked so well that hers also was undetectable on mammogram by the end and the surgeon had to use a bit of guesswork and the original mammo pics to know where to do the lumpectomy. Luckily he was a good shot and got the last few cells that were lurking, but my hospital has apparently now changed its policy and tattoos the extremities of tumours onto women before chemo starts so that its location can be determined at the end if chemo works well.

I really wouldn't like to suggest anybody make decisions one way or the other, it's a really personal thing. I asked my surgeon what he would do if I was his wife and was guided by that response.


Re: Chemo before surgery

I am 29 and was only diagnosed last week and have been given the option of a full mx or starting chemo first. Im worried that if I start chemo first then the tumour could be non-responsive and end up spreading did anyone else worry about this? I have been booked in for a full mx on 28 jan if i decide against chemo first but I want t o be as clued up as possible. Did any one find that the tumour didnt shrink by having chemo first? My dr has said that if i try this first and the tunour does shrink then i could have a lumpectomy rather then a mx unless the tumour shrinks but leaves random strands of cancer behind. Im terrified. I have 2 children under 4 and need to @get this right@ for them if this makes any sense


Re: Chemo before surgery

Hi Wiggy 99,

Just something to add to the above comments. Please make sure that your consultant 'marks' in some way or other, exactly where the tumour is.
They can completely disappear! I too had chemo first, which was definately the right decision for me. My tumour was 3cm and after 8 sessions of chemo, 4 X AC and 4 X Tax, it was indetectable on the mammogram and ultrasound on the morning of surgery. I was lucky that I had a mole immediately on top of my lump, so the consultant was able to remove a section of breast tissue, surrounding where the tumour had been. I have spoken to others on here, who had to have a mastectomy because the surgeon couldn't be exactly sure of where the tumour had been.

Your consultant will know that this happens, but you need to be aware that if it is shrinking quickly, you will need to go in and have tiny metal pins put in so that they can locate where it was when you have your lumpectomy.

Another advantage to me, was that after surgery the consultant informed me that I had 10 lymph nodes that had been infected, but were by then clear. So I believe that I gave myself the best shot, by having the chemo in my body as soon as was possible + I didn't have the worry of knowing that so many were affected, only knew at the end which didn't seem so bad.

Good luck with your treatment,



Re: Chemo before surgery

Hi All, Thank for your replies. I'm very happy to be having chemo first for a few reasons - 1. I'll know if chemo is working. 2 Will give me a huge boost if I know the tumour is shrinking. 3 Regardless of the extent of the surgery I need at the end of chemo, it will give me time to get my head around it rather than being whisked off for mx without time to think. Lastly, I've been chatting to people in the USA and Canada where there are lots who have done it this way and they all seem very happy with it. I was just worried I might be kidding myself and someone may tell me something to make me think I should be going for surgery straight away. thanks agaon x


Re: Chemo before surgery

Hi had my chemo first and was scanned after every two. Just as well as I have very good response on the first 4 and no further shrinkage after x2 of the second sort. Was actually a bit gutted at the time that I was taken off chemo (felt I hadnt had enough to clear me), but on the plus side there was something to measure against and had I had mx first I would have continued with the full x8 chemos not knowing that the 2nd lot werent helping.

I didnt find it strange to have the chemo first, as I didnt know enough about BC to know that its not always the case. That was April 08 and touch wood, just started the last leg of treatment - Herceptin and all going well so far.
Ness1. xx


Re: Chemo before surgery

Evening Wiggy99,
I started FEC chemo @ end of november08 and now have had 3 cycles of the weedkiller.I have still to get another 3 rounds and will get surgery...mastectomy in April 09.The reason for neo-adjuvent chemo first is to reduce tumour size and kill off rogue cancer cells lurking around.I am due CT scan on monday to accurately assess the size of the tumour now.
So,in answer to your question...I feel ok about the chemo first...as I can see for myself that the swelling and inflammation is reducing & therefore the treatment appears to be working.In addition I discussed this with the oncology team it seems that this is more common practice in America.
I just cracked on with it & adapting to the SE as best I can.
Wishing you all the best with your treatment.
Pauline xxx


Re: Chemo before surgery

Hi.i was diagnosed Nov 2007 and had chemo first cos I had a very large tumor so no option really! At least with chemo first you can judge how effective that particular chemo is for you, and for some, not me though, it can mean a lumpectomy rather than mastectomy.
Hope all goes well with your treatments.


Chemo before surgery

Is anyone having Chemo before surgery and how do you feel about it?