I did chemo first. I also had lymph node positive for ER+ cancer, oncotype score of 28. My surgeon is the one who suggested I do chemo first in hopes of having a lesser surgery. I saw the oncologist a week later who did the oncotype DX test on my original biopsy, and also started me on Letrozole for 3 weeks. My KI67 score responded well during those 3 weeks but because of the lymph node involvement and high oncotype DX my oncologist said I would benefit from chemo. He agreed with to surgeon to do chemo first. Because my cancer isn’t palpable I had a breast MRI done last week, after AC chemo and before Taxol. My cancer has shrunk significantly.
Bottom line, my medical oncologist was a huge help in helping me decide what route to take. I asked questions and he helped me understand the treatment plan and then I was comfortable with going through chemo. I didn’t want to have chemo at first but it is doable and gives the best chance for a cure so I’m good now.