Chemo first vs Surgery first?

Posted by journey99 @journey99, Mar 13, 2023

I am scheduled for a lumpectomy next week and from a biopsy we know lymph node (s) have to be removed. The original plan was I take Letrozole for 3 weeks, test Ki 67% from surgery to see if my body responds to the Letrozole. My numbers are all borderline so concern has been over treating. If it was responding then probably would not recommend chemo. Last week we learned my Oncotype DX is 30 therefore now chemo is recommended.

So my dilemma is do I go ahead with the surgery as originally planned, knowing I will then do chemo. Or do I change course and start chemo and then surgery? The benefit of chemo first would be to possibly lower the number of nodes that may have to be removed. I am struggling with the decision. Any advice is helpful.

Interested in more discussions like this? Go to the Breast Cancer Support Group.

sally484 | @sally484 | Nov 3 8:46am

I had chemo and radiation first..............then surgery. They told me the tumor was all but disintegrated by the time I had surgery. They removed several lymph nodes and what was left of the tumor. which wasn't much!

flatland | @flatland | Nov 4 10:38am

I had chemo first as well, then radiation, then a lumpectomy. My tumor was also almost gone. Chemo was the worst, and it was better for me to get that out of the way, and everything after that wasn’t as bad. Good luck! Go get em!

heidilee67 | @heidilee67 | Nov 5 7:01am

I had 18 weeks of chemo before surgery- they wanted to see if my cancer responded to it (invasive ductal carcinoma). It did respond but there are more concerns than just the cancers they marked, so my surgery will be this month. Although one breast has been the problem, I opted for bi lateral mastectomy. I’m HER positive so will continue with treatments until June of Herceptin. If I’d been diagnosed with a lesser aggressive cancer they would’ve treated me the same way your oncologist suggests, from what I’ve heard around my chemo center that’s the norm. Good luck to you. We will all get through this strange time!

sally484 | @sally484 | Nov 5 7:52am

I had chemo, radiation and then surgery and the Dr. said my tumor had just about turned to powder. I had several lymph nodes removed and a lumpectomy. Am now on Exemestane and doing well.