Chemo first and surgery after

@Vangirl  you're a clever cookie, I agree 😊

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. 
https://www.medicalnewstoday.com/articles/neoadjuvant-chemotherapy

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. 

hi hello @JuneXie, just wondering how you are going. Take care and do let us know how you are doing xx 

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

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. :( 

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. 

@cath60, Allyjay, LittleBluewren and Christable03 , thank you all for sharing your experience with me, it is really helpful and eased my concern. My chemo starts next Wednesday and I will try my best to be positive and confident to go through this process and hopefully get a good outcome!

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