Chemo before surgery OR surgery before chemo???

I'm not sure how they calculate it @RR.  I suspect it's known size, advancement, type, aggressiveness and whatever else is in the mix.  I had surgery first - mine was ILC - first thought to be Stage 2 and about 2.5mm, then found to be in the nodes, so Stage 3, Grade 2 and 4.5mm but not aggressive.  So back into surgery for mastectomy and clearance.  Just long enough for surgery to heal and I started chemo - 4 x 3 weekly doses of AC and then on to 12 x weekly doses of Placlitaxel, which I started on Thursday.  Then it'll be rads, then hormones.  While the surgeon is convinced he got all of the cancer, he said there's no point taking chances that anything has escaped and is floating around.  I am 54 and have 3 kids, the youngest of whom is 12.  I'm different from @kmakm - I found the surgery, while confronting, easy to get over.  Chemo takes a special type of fortitude!
Anyway, ask your medical team exactly what is being suggested and why.

@kmakm and @AllyJay have it in a nutshell well done ladies. I had my left mastectomy as I had triple negative stage 2 grade 3 bc aged 43 May 2016 then I had 8 rounds of chemo 2 weeks apart. 4 AC chemo and 4 paclitaxol. Then I took the right boob off as a prophylaxis. Wish I’d had the immediate recon and would of had I’d known the wait times would be several years in qld. But st the time it was the last thing on my mind. If I’d had chemo first I would of had time to research my options more too. Chemo can be shitty love but it is doable. Listen to the chickys above when it comes to support. You will soon find out who your real friends are. Margie xx

@kmakm - enjoy your breakfast, the food will make you stronger!!!

@AllyJay - you made me tear up, thank you xx I am 45 and it is just awful - you sound like you really have had a long run of treatment, I truly feel for you. Take care and keep sharing your positive approach :smile:

RR, it's a rollercoaster as I'm sure you're discovering! I've had a bad couple of days and am hoping today will be better.

At this very minute my biggest issue is the thumping headache I've woken up with! On the plus side I am actually hungry for the first time since my operation eight days ago. I'm told that's a good sign.

I have anxiety issues and the best advice for me during breast cancer is to break things right down to day by day, sometimes hour by hour. To try not to cross bridges until you come to them.

Right now I just want my breakfast!!

Hi there @RR . I was diagnosed with Grade 3 Stage 3 triple positive breast cancer with multifocal tumours and node involvement on the left side. I did six months of chemo, 12 weeks of AC chemo followed by 12 weeks of paclitaxol and herceptin. The herceptin continued afterwards for a total of 11 months. Four weeks after the taxol finished I had a bilateral mastectomy with full node clearance on the left and sentinal node on the right. Your team will know which is better, before or after surgery. In my case, it was explained to me that shrinking the two tumours and zapping any that most certainly had escaped into my blood or lymph system by that time was crucial. I too was keen for them to get out the weedwhacker and chop them off as soon as possible, but was told that the cancer in my breasts would not kill me, it would be seeds they sent off to other parts of my body that would. From my experience, having the chemo first and then the surgery after was the best for me. The pathology reports from the removed breasts showed NO sign of cancer, only the empty beds where it had been. The involved lymph node was essentially an empty husk of dead tissue. The cancer had taken over the entire node, but was now stone dead. I went into chemo with a strong (well relatively strong, I have other medical issues) body and the surgery afterwards was surprisingly easy to bounce back from. I was 58 at the start of this  crapfest, and will be 60 next month. Yes your two little girls need their mother...they can have you at half speed for a short while, so that you will be there at their weddings and there to cradle their bubbies when they arrive in years to come. You've got this, and your sisters (and a few brothers) in arms are here to support and cheer you on too. Sending the biggest (((hug))). AllyJay.

@kmakm - Oh, dear! I hope you are feeling ok? I haven't met with my oncologist yet, so will know more when I have that. They are suggesting chemo and then surgery, but I was just wondering if this is the norm.

Hey brave mumma, have you been told what your chemo is called? While they all have things in common, they do vary (as do our physical responses), and it can sometimes be helpful to have chemo specific advice here. There is no 'normal', we're all different depending on our diagnoses.

I had TC chemotherapy, which was four doses given at three weekly intervals. I am currently in hospital recovering from a bilateral mastectomy and reconstruction. Are you thinking about immediate reconstruction? You haven't mentioned radiation so I'm presuming you're not having it.

Anyway, I won't tell I found chemo to be pleasant, because it's not, but nor was it the end of the world. I have four kids. You will need as much help as you can lay your hands on so if people offer, accept! I was petrified before it started (had a full blown panic attack two nights before) but most side effects are manageable these days. Never hesitate to ask for stronger meds!

My order of treatment was dictated by my diagnosis variables, as yours will be I'm sure. Do you like and trust your medical team? Be guided by them, and your gut.

If pressed, and you do have a choice, I'd say chemo first then mastectomy. Chemo is a hard slog, but it is transitory. A mastectomy is forever. I would not like to be lying here processing the loss of my breasts whilst also contemplating starting chemotherapy.

All the very best. You can do this, you'll get through, keep your eyes on the prize. Big (though very gentle right now!) bear hug. K xox