Chemo first and surgery after

JuneXie Member Posts: 3
edited June 2023 in Newly diagnosed
I’m 47, single and no child.  Diagnosed on 31 May 2023 with early breast cancer, ER+ PR+ HER2-, Stage3, large tumor 8cm, 1lymph node involvement , referred to Peter Mac Cancer Center, and recommended neoadjuvant  treatment (I.e. Chemo prior to surgery ). Im concerned  that as a hormone positive type , would chemo first approach really /likely shrink my tumor ? Is there any member who is hormone  positive and also took chemo before surgery can share your experience with me? I’m totally stressed out and terrified. 


  • Cath62
    Cath62 Member Posts: 1,241
    Hi @JuneXie

    Sorry you are going through this situation. I hope you have some good family and friends supporting you.  I was not exactly in the same situation as you but it is common for chemo to be done first to shrink a tumor and kill any roaming cancer cells. Chemo can shrink tumors and i am sure others on here have had success in that way.

    Your oncologist should be able to explain why they recommend chemo first. Do you have a breast care nurse as they too can walk you through things. 

    When first diagnosed it is simply terrifying and overwhelming. There is so much to take in, all the new terms and what they all mean. It's hard to generalise because each of us has our own pathology and really no 2 are exactly the same. 

    Treatment is very successful these days and while it's definitely a tough road, you are going to get through it. You need to keep busy and look after yourself well to get through it all. Eat healthy food, drink lots water and take in some exercise if you can as it really helps. Take deep breaths or try meditation as it is also helpful.

    It can also be beneficial to talk to a counsellor or psychologist. I am sure Peter Mac would help there or a breast care nurse. Breast cancer can be alot to process and sometimes having a professional to talk to can help. I had a couple of sessions with a psychologist and it did help me. 

    Best wishes to you. This is a great forum and all questions and concerns are ok to talk about here,  it is good support. Take care
  • LIttleBlueWren
    LIttleBlueWren Member Posts: 88
    Hi JuneXie,
    I was diagnosed Hormone + in 2018 and had chemo first, then SMX with nodes removed (1 showed positive) and then rads.
    My SMX showed the breast tissue had responded to the chemo. I'm not sure why it is done in that order though. All subsequent US and mammograms show no sign of anything now which is great.
    I found chemo to be a pretty good experience with minimal discomfort (except for the hair loss bit). I was able to walk a lot and had only a couple of days of really bad fatigue.
    Write down all of your questions for the Dr and BC nurses they are really helpful! And that way you have a record of their answers.
    Wishing you all the best.
  • Christabel03
    Christabel03 Member Posts: 80
    Hi @JuneXie I was diagnosed HER+ in October 2021 with a large tumor and a lot of lymph node involvement. I started chemo first and that went for six months then it was surgery. I can remember feeling as you have described no knowing if all this chemo would shrink my tumor and was it really working while I was going through it, but when I went for my ultrasound prior to surgery the chemo had certainly had an impact and had significantly shrunk the tumor. 

    I think in all this at the time of diagnosis, the brain tells us we just want to "get it out" and we should be having surgery like right now. It is so hard but you have to trust in the medical team you have around you and trust in they are choosing the right path of treatment for you. 

    Wishing you the best and sending you a massive hug xx
  • noosa_blue150
    noosa_blue150 Member Posts: 210

    This is a good link with explanation of why some breast cancer patients have chemo first, then surgery 

  • Shinny
    Shinny Member Posts: 1
    Hi @JuneXie, I am just middle of my chemo with the same cancer type- both hormonal positive and her2 negative. 5.5cm tumor with 1 lymph note involved. I must say I was thinking the same thing but now I can feel my cancer area is a lot softened. 

    My oncologist ordered 2 stages of chemotherapy and the first one was hard. It lasted 8 weeks - 4 times every two weeks. Then I am on the second stage of chemo and it is milder for me. My surgeon saying this second around is the one really killing cancer cells.

    I believe you will have similar standard treatment as I am going through. I have 10 more chemo left- once a week, then surgery- Mastectomy, then radio therapy and hormonal therapy 

    please get any help as much as you can around House work and have some friends around you. Hope everything goes well for you 
  • JuneXie
    JuneXie Member Posts: 3
    Hi @Shinny, I commenced my first chemo on 14th June ( A/C every fortnight 4 times , followed by Taxol every week 12 times). With A/C, I had all sorts reaction, dizziness , dry vomiting, reflux, heart burn, vaginal bleeding , toothache…, will see my oncologist to address these issues before the 2nd A/C. My surgeon hasn’t confirmed the surgery type in last consultation, but indicated that she wants chemo first on me to shrink the tumour so the lumpectomy could be possible. Given the size of my tumour being 8cm, i guess that my surgeon said so (lumpectomy) to just comfort me, where mastectomy is most likely. Im scared of mastectomy and try not think of it and focus on going through the chemo at the moment. :( 
  • Ktre
    Ktre Member Posts: 93
    Hi @JuneXie, you have the same diagnosis as me, ER+, PR+ and HER-,  I went the opposite direction to you, had surgery first then chemo, my team were concerned that my cancer was aggressive as I had what looked to be 5 tumours all on the left side of my right breast, basically found from 1oclock position to 6oclock. At the time before surgery I had no lymph node involvement according to biopsy. Full mastectomy done on right side with sentinel node biopsy at same time to confirm no nodes involved. The the time frame from original biopsy and first surgery was approximately 2 months (public system) final tests from surgery revealed 3.5 nodes involved and was 2 aggressive tumours that were branching out like trees causing it to look like 5. Full auxillary clearance happened 2 weeks later, another node involvement found, full scans done and chemo booked, AC ever 2 weeks- changed to every 3 weeks after scans revealed spots in the liver.  Oncology were concerned that if cancer had gone further into liver my body would not cope with the heavy dose of chemo and then possible change to different meds if I became metastatic. Scans after Chemo revealed no more evidence in the boob area and spots in the liver reduced from original 5 to 3. This confirmed stage 4 metastatic breast cancer to the liver and medication changed to daily oral meds for the rest of my life. I often wonder if chemo had been done first and pushed to start quickly it might have stopped the node and liver involvement. Stay positive, keep fighting. You've got this!
    Sending positivity your way while you get through chemo, the AC is not easy and I can relate to the dizzy feelings, toothaches and the reflux. The oncologist will have great meds to help you deal with those side effects and utilise the oncology nurses as much as possible. (I had a number I could ring to discuss side effects and get help if needed) Also reach out here anytime was we ask want to help. Xxx sending positivity your way and thinking of you
  • Edithead
    Edithead Member Posts: 12
    hi hello @JuneXie, just wondering how you are going. Take care and do let us know how you are doing xx 
  • Brenda5
    Brenda5 Member Posts: 2,423
    I think the chemo first idea is to potentially reduce any chance of the cancer extending into other areas. Nip that one in the bud and the bonus is to shrink the existing cancer before opening up the blood stream in surgery. Make it sick first then remove it. Good plan. 
  • Vangirl
    Vangirl Member Posts: 350
    The idea behind Neoadjuvant chemotherapy is to attack not only the cancer cells in the primary tumor but also to destroy any cells that may be circulating in the rest of the body. If you think about it, it makes sense to do this first then remove the primary tumor, which will now be much reduced in size.
  • Tarma
    Tarma Member Posts: 73
    @Vangirl you're a clever cookie, I agree 😊