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why chemo before surgery?

laurissa's picture
Posts: 773
Joined: Sep 2009

Why can't doctor just take it out right away? He says to shrink it first. I guess they know what they're doing.

Posts: 2515
Joined: May 2009

From what I understand, when they want to shrink the tumor first is because of the size of it...easier to remove, completely, a small tumor than a large one and it can conserve the breast if only a lumpectomy is needed and many other reasons. Trust your doctor and ask him anything and everything. Someone who has a similar situation will probably be able to give you more reasons.
Prayers and best wishes

Marcia527's picture
Posts: 2749
Joined: Jul 2006

Mine had to be shunk first because it was so large he wouldn't have enough skin left to close with. I had a 6cm and a 3 cm and another tumor. So you could say I was full of it. He said I'd need skin grafts if I didn't have chemo first. It also kills all those stray cancer cells floating around in the body. So I had chemo first and after surgery. This was in 2003/2004. I was stage 3a before and after surgery he said I was downsized to stage 2b.

Cat64's picture
Posts: 1192
Joined: Aug 2009

I thought the same thing when I was first diagnosed-just get it out of there! My surgeon said if he were to take it out now, I would be left deformed or would have to have a Mastectomy. I chose to do Chemo 1st to try to shrink it, then a Lumpectomy. Mine at last measurement was 2.8cm. I am somewhat small so it made sense. I am only 44, so I would like to keep it as long as I can! Trust that they know what they are doing and are doing what is best for you & your situation.

e_hope's picture
Posts: 371
Joined: Sep 2009

They oncologist will ask you if you want to shrink the tumor to try for a lumpectomy if the tumor is big and will leave you deformed if they remove it at the current size.. I was only a large A cup with a 3.5cm tumor at the 12 o'clock position and my oncologist gave me a choice.. TRY shrinking the tumor for a lumpectomy or a mastectomy.

I choose to have a double mastectomy. I didn't want to try to shrink the tumor, because there is a chance the tumor its self won't shrink just become less dense with cancer (if this happens you will still need a mastectomy). For me... I didn't want to take that chance.

Its a personal decision. I do know many woman who have done the chemo to shrink their large tumors with successful lumpectomies after..

New Flower
Posts: 4299
Joined: Aug 2009

Hi Laurissa,
I had radical Mastectomy too and have no regrets about my decision. My hope is that having mastectomy should avoid Recurrence. Immediate Reconstruction is possible too. It is a very personal decision.
Good luck

Posts: 12
Joined: Sep 2009

Excellent question and you have already gotten some excellent answers in reply.

And you are right that now is the time to ask questions and get info.

If you haven't already done so, you may want to see if a you live near a major university cancer center and if so you may want to get a 2nd opinion.

One of the most common reasons for taking chemotherapy before the surgery is to shrink the tumor in the hopes of needing a smaller surgery. If you would need chemotherapy after the surgery if you don't do it now, then some feel taking the chemo first loses little and has the chance for a smaller or easier surgery.

I have known of people who had less surgery and were very happy with that decision. I have known of other people who had more surgery and were happy with that decision to. As others have said its a very personal choice. In my opinion, before making that choice you would like to understand your options and have a good idea of the "plusses" and "minuses" of either choice.


mimivac's picture
Posts: 2147
Joined: Dec 2008

The ladies here provided some excellent answers. I would like to add that chemo before surgery also allows the oncologist to determine if the particular chemo regimen is effective on your tumor. If the tumor disappears in response to the chemo, then you have a pathologically complete response, which is excellent for your prognosis. If the chemo isn't shrinking the tumor enough, the onc. has the option of trying a new combination or additional agents. So, it can give you that added advantage as well. In most cases, the tumor will not grow or spread on chemo, so you don't have to worry about that.

I had a 2.6 cm. tumor and had it removed right away and then lumpectomy. Although I believe that my chemo was effective, I will never be 100% sure since I had no tumor to test it against. Good luck with your decision.


Kylez's picture
Posts: 3765
Joined: May 2009

I think they normally give chemo first to shrink the tumor. And, it can also be to see if the chemo that your oncologist has chosen for you to take is going to work for you. Good luck!

Kylez ♥

Posts: 3660
Joined: Aug 2009

In my case the surgeon refused to think of doing surgery until chemo had been done/tried. My understanding is that it depends a lot of the type of BC as far as what is the protocol. I have Inflammatory BC which is very agressive and had progressed very rapidly. Surgeon did not believe that he had much of a chance of getting it all unless it was shrunk first so I'm now on my 3rd dose of A/C. Dr. T. (chemo Dr.) was pleased with the progress from the first dose but wasn't with the progress from the second dose but went ahead with the third dose - that was last Wednesday. Will see him next Wed and find out then rather he wants to continue with the A/C or switch to something else. Time will tell.


Sam726's picture
Posts: 233
Joined: Sep 2009

I am having chemo first...tumor not that big, 2.5 cm. Doc says get meds in you first to kill cells floating around and it also shrinks the tumor so less breast to remove. Makes sense! I trust my docs...I am going to one of the top centers in the country so Im sure they know and Im sure your doc is smart guy too!! Good luck..

ladybug22's picture
Posts: 647
Joined: Sep 2008

rague hang in there i had i b c hugs to u

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