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Chemo first vs Surgery first?

Breast Cancer | Last Active: Nov 5 7:52am | Replies (24)

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@lesleyjt

My dr wants to treat my stage 2B IDC with node involvement HR+ HER2 - cancer with chemo first approach then surgery then radiation. While I wait for an apt with her March 28th, trying to understand rational to do chemo first Vs surgery first.

Logically I feel like removing the primary tumour then treating the body makes more sense to me. My breast can’t be saved as the tumor is surrounded by calcifications that cover over a third of my b cup breast.

Any insight you can share would be much appreciated. Thanks in advance.

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Replies to "My dr wants to treat my stage 2B IDC with node involvement HR+ HER2 - cancer..."

@lesleyjt I noticed you are on a couple other pages since your diagnosis, welcome to the club you never wanted to join. You will meet the nicest people here. 😁
Sometimes a doctor will recommend shrinking the tumor with chemotherapy first. A few reasons might be aggressive looking cells in the tumor. The large size of the tumor, or it might be something completely different. This has been studied extensively and certain cancers do have better outcomes with this plan.
I know the situation is a little different but here is a link to another recent post about chemo before surgery.
https://connect.mayoclinic.org/discussion/lymph-nodes-surgery-first-or-chemo-first/
Did your doctor explain a reasoning behind this choice? Are you comfortable asking?

Perhaps they want you to have chemo first because they know you have cancerous cells within your lymph nodes. They might want to begin chemotherapy treatment to reduce the risk of having those cells circulating throughout the body.

Also, for some of us (I was Her2+), having chemo first helps gauge how effective treatment is/was for our tumors.

Hope this helps. ♥️

I was dx 11/21 with TNBC BRCA+ after doing a lot of research after dx learned there were instances where they did chemo before surgery and that is the course my onco recommended. I had lump in breast and lump in left lymph area. Chemo shrunk everything down significantly original breast was just under 5cm reduced to about 1.7 after chemo; lymph shrunk from 2.7 to .8 - clear evidence Chemo worked and this was after my first round of just the A/C. By the end of Taxol there was almost nothing there but since when I had my biopsy I had a marker inserted; which probably didn't make much difference since I was having bilateral performed and choosing to go flat. Chemo, done; surgery, done; now I'm having radiation since there was a miniscule spot in one of the lymph pathology samples. After this I believe I move onto maintenance meds and monitoring. It's been a journey - I did my research, informed my husband of what I found and what I was choosing and my reasons and asked him to join me in those meetings I felt he was needed for information I was going to receive. I also told him the information I wanted to know and asked him to help be get those answers or to find out when and where I could get those answers. I was actually surprised at how calm I was and how focused I stayed during the meetings. I carried with me a note pad and was able to get answers to most everything I had questions about each time I had an appointment - even if it was for treatment so I could pose the question before my next appointment.