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Surgery after chemotherapy?

Posts: 4
Joined: Sep 2010

Hi there-

I'm new to this forum but not new to bc - I was diagnosed in early May w/invasive ductal carcinoma. I guess you'd call it triple positive; it's ER, PR & HER2 positive. No lymph nodes seemed to be involved except a couple of suspects toward the center of my chest that they don't want to remove.

My tumor was over 5 cm, however,and my oncology team recommended I do chemotherapy with Herceptin first to try & shrink the tumor before surgery. Has anyone else done this same regimen? I'm an A cup on a good day, so didn't have much to work with, and the tumor was actually visible by the time I started treatment w/Taxotere, Carboplatin & Herceptin (T&C every 3 weeks, Herceptin weekly).

I have to say, I was amazed at the effect the meds have had on the tumor. I just finished up chemo# 5 of 6 last Wednesday, and we can't find that tumor by touch at all now. I actually started noticing it shrinking after the first treatment; that sure made any/all chemo side effects seem a lot easier to bear. It was so odd; that tumor grew so big, so fast, then the meds just absolutely knocked it for a loop. I won't know for sure, obviously, just how far gone it is till after treatment #6 & a PET scan, but I'm pretty optimistic.

I've searched through various topics & didn't see anyone else who'd done the surgery after chemo & what their experience was like. I'll start radiation after the surgery; I think 7 weeks' worth.

My side effects have been the usual; my hair thinned out so much by about 10 days after the first treatment i got disgusted & shaved it. I do have baby bird fuzz now, so at least some of it's growing. No nausea, but varying degrees of rash, constipation, diahrrea, numbness, mouth sores, and interestingly, a lot of aching in that breast. Plus fatigue & what i'd describe as a 'tired' heart - probably from anemia & the Herceptin. Oh, and don't get me started on the hot flashes :)

Anyway, I'm really excited to be almost through the chemo & would love to hear from anyone who did surgery after chemo, also more on what i can expect from the radiation. I'm a little nervous about that. Thanks very much for any advice/commiseration/stories you can share!

cavediver's picture
Posts: 607
Joined: Apr 2010

I had 3 cycles of chemo to shrink my large tumor,.. it was almost nonexistent ...then had a mastectomy....margins clean, but had lymph nodes positive. I followed with another 5 chemo, and I will be starting rads in another week for 35 treatments. It is aggessive treatment, but we want to get this taken care of, right? I can/t tell you what to expect from the rads since I have not started yet, But I am glad that I am done with chemo and the surgery! Are you having surgery and then more chemo?

putzie's picture
Posts: 66
Joined: Apr 2010

I was diagnosed with IDC, her2neu and estrogen positive, 1.2 cm., 1 lymph node involved. This was on a Friday afternoon in March. I was petrified, didn't know where to start, and the doctor that gave me my dx told me to contact a surgeon. It was going to be 2 1/2 weeks before I could see him and I just couldn't walk around in a daze for that amount of time so my hubby and I went to Mayo Clinic the next week. I saw every doctor and had every test I needed. Everyone there suggested chemo first. I was skeptical, thinking I wanted cancer out of my body ASAP! Well, I listened to them and started chemo at home the next week. Same regimen as you Bunny. They want to make sure the chemo will work for you and it sounds like it has!! I had surgery 4 weeks after chemo, lumpectomy and lymph node removal (0/9). I would recommend this structure to anyone going through what we are!! I liked getting the hardest thing out of the way because chemo takes so much out of a person.
I feel great after surgery and am now even playing golf 5 weeks past. I will start radiation in two weeks so I don't know how that will affect us but I heard it is nothing compared to chemo...we may get a little tired and our skin will be like a sunburn (they have creams for that, too)!!! I wish you the best...it sounds like you have a great, positive attitude and that is what kept me going as well. Hang in there...there is light at the end of the tunnel...I wondered at times, but it IS there!!!! Good luck and God Speed to You!!!

Cat64's picture
Posts: 1192
Joined: Aug 2009

Welcome to our Sisterhood! So sorry you had to join this way, but glad you found us. You will find this site extremely helpful.
I was also diagnosed IDC ER/PR- Her2+, My tumor was 3cm before surgery, I did only 2 rounds of Taxotere/Carboplatin. (Different Onc-so no Herceptin) I am a B and my lump was very noticeable and hard. After the Chemo, it shrank alot & was soft. Couldn't tell you by how much, but enough so that my surgeon was amazed! I had a Lumpectomy,(he did a fabulous job & couldn't be happier with the results!) 3 LN's removed,(all-) did 6 weeks of Rads & just finished my last Herceptin. I also had 4 rounds of T/C/H after surgery. Rads went pretty smooth in the beginning for me. It wasn't until about the 3rd-4th week that I even became red. Used aloe spray at first, then Aquaphor, in the end used Silver Sulfadiazine. The fatigue was pretty rough, tired alot, but overall, it was nothing compared to Chemo! I finished 7/27 and my "tan" is just about gone. The hot flashes...whew! I can soooo relate! I wake up at least 3x/night in a massive sweat, then freeze, what I wouldn't give for just one uninterrupted night of sleep!
Glad to hear you are almost done with the poison, sounds like you've had a rough time. You're almost through the toughest part though IMO.
Feel free to come back & post anytime about anything.
Take Care
♥ Cat

Marcia527's picture
Posts: 2749
Joined: Jul 2006

I had chemo before surgery to shrink the 6cm tumor, also a 3cm tumor. 4 cycles of A/C. Then had to have 4 more cycles after surgery of Taxotere. Cancer was a grade 3 and did shrink it but not enough. I was downsized from stage 3a to 2.

Radiation didn't make me sick like the chemo did. I got a little over-done but the radiation was easier to deal with than chemo for me. I was pretty sick on chemo. Nothing about treatment is easy but just hang in there and it will be over and done with.

Posts: 4
Joined: Sep 2010

WOW - thank you all so much for your posts!! Everyone's advice has given me a fresh, 'kick some'a' attitude again. I think getting through chemo #5 was slowing me down & making me a little discouraged. O.k. - I'll be honest - grumpy & whiny. But I'm back now :)

I'm especially encouraged by the reports about the rads, I was a bit nervous about that part. Isn't it odd how the unknown is so much more frightening than just dealing with the situation. The docs can reassure you all they want, but until one of them says they've had the treatment themselves, I'm not buying it. Hearing from fellow survivors means a lot.

It sounds like some of you did just a portion of the chemo before surgery; then finished up with more. I think in my case i'm kind of glad to be doing one thing at a time. It sounds challenging to do chemo after surgery when your body is trying to heal (even if they wait awhile). I did have a minor surgery right before chemo# 2 - my gynecologist gave me a D&C to stop heavy bleeding. I think that might have made my chemo side effects a little more complicated. By treatment# 4 I felt pretty good again.

I'll definitely report back on how much of this tumor is left, because mine was a dandy. Maybe I'll start some sort of a pool at work & make a little cash on the side. They all think I'm nuts anyway; I've had a lot of fun with different hats, scarves & wigs. They never really know who/what will show up when I grace them with my presence. You all hang in there too - one thing I've learned from this is that you can't stop living for even one second. Absolutely take care of yourself & don't miss any opportunities to have fun. You'll be glad you did.

Posts: 3659
Joined: Aug 2009

'per surgery' chemo - is not the 'usual' but it is not rare either.

I'm IBC so not the same Dx as you but I had adjunct chemo first. Surgeon would not do surgery until chemo had been done to try to shrink and get margins before he had any chance of getting it all. So I did 4 A/C doses which did shrink it and gain margins. Surgery was 2 weeks after the last A/C and 3 weeks after surgery I started 12 weekly Taxol. The week after the last Taxol I started 25 rads.

For me, A/C wasn't bad - only tired 2 days out of 2 weeks. Taxol was bad - was tired 2 days out of each week and totally, utterly, completely exhausted the other 5, could not sleep without sleeping pills. Started Femara 2 weeks after last Taxol. Rads were easy - they started the week after the last Taxol and I just kept feeling better the longer they went - until after them. I burned very bad but it didn't show up til the last 3 rads and ws only a mild 'sunburn' until the day after done then blistered bad in the entire radiation area - 6 weeks for the last of the scabs to come off.

We're all so different.


chriskaput's picture
Posts: 109
Joined: Jul 2010

Seems like we have alot in common. I was diagnosed in early May also (DCIS) with a 2.7cm tumor. I started my chemo 4 x AC and 12 x Taxol at the end of May. My last treatment is Oct. 4th. I cannot wait! My tumor has shrunk "significantly." My surgeon and onco. are pleased. I expect surgery sometime in early Nov. (lumpectomy) and then 7 weeks of rads after that. I am positive for clean margins after the surgery and waiting for this wild ride to be over already as I am sure you are too.

Wishing you all the best : )

Posts: 4
Joined: Sep 2010

We do have a lot in common! My last chemo is Sept 29th & my tumor is pretty much impossible to find manually. I'm actually looking forward to seeing the PET scan when I finally get it. Good luck to you on the surgery & rads; I'll be thinking of you~~

Posts: 6
Joined: Aug 2010

Well I was diagnosed in May the 12th. I have went thru Chemo, 4 AC every 2 weeks and 4 of Taxol every 2 weeks. My last Chemo was on 9/16/10. On the 27th I get an ultrasound and mammogram and I meet with the surgeon on the 29th. anything has to be easier than the chemo! My left breast had the cancer and it was 3 1/4 cm and was a stage 2. After surgery I go to radiation for 5 weeks. thry are talking about taking the lymph nodes out. I have heard it makes your arm swell? Has anyone heard or went thru this? Your sister in pink!

putzie's picture
Posts: 66
Joined: Apr 2010

I had a lumpectomy and lymph node removal on August 11th (was diagnosed with cancer in my first node but at time of surgery 0/9 were cancerous, Thank You, God). So far I am still numb under my arm and partially to my elbow. I am happy to announce there is no swelling and I have been having no problems. I am even playing lots of golf!!! Be sure to exercise your arm with very light weights, i.e. soup cans, by lifting your arm over your head and holding a stretch. My doctor gave me that advice and I have been doing great. I am sure you can too!!! If you do encounter swelling, please contact your surgeon as this can be lymphodema and needs to be addressed. :) Good luck and God Speed!!!


DianeBC's picture
Posts: 3886
Joined: Jun 2009

Hi Bunny. I had a lumpectomy first and then had radiation treatments, no chemo. Just wanted to say hi and to welcome you to this great site.

Good luck to you,


Posts: 598
Joined: Sep 2009

I had huge tumor. 12:00 postion. 5.3cm watching it grow. Grew in 2 months. Also triple positive with 18/20 lymph nodes. I had surgery first. I don't know why. I work in surgery and showed my surgeon the tumor and told him I wanted this off my chest. I didn't even look like it was part of the breast, it sat so high. Few blood work and MRI on a Fri and surgery on Monday. I already knew what it was. Worked in surgery for 18yrs. It was very uneven and lumpy. Sorrry that just fell out all over the place. To answer ur question. I don't know why they shrink the tumor first vs surgery first. I never have asked my onc. Think I will. So jump ahead now, 15months out and so far so good. I really sucked cause of the nodes. If you find the answer to ur question, please post. I've always wondered. Katz

missingtexas's picture
Posts: 146
Joined: Jul 2010

I did surgery after chemo. 8.8 cm tumor. The pathology report showed a 93% reduction in tumor size. All of the invasive ca was gone. 3 positive lymphnodes with dead cells in two others. I will do the radiation pretty soon. They said I had to be healed and since I have to have my drainage tube put back in, it will have to wait a bit longer.

Gabe N Abby Mom's picture
Gabe N Abby Mom
Posts: 2415
Joined: Sep 2010

My treatment plan is chemo (TAC), then mastectomy, followed by radiation. I'm triple neg and IBC, and just completed my 2nd chemo treatment.

Not only do your docs want to shrink the tumor and see if your cancer responds to chemo, but chemo is a systemic treatment. So that means if any of the mean nasty little cancer cells are trying right now to settle somewhere else in your body, the chemo can kill them before they find a home.

The surgery and radiation are targeted, only effecting the breast. So it makes sense to me to apply both systemic and targeted treatments to cancer. After all, the goal is to get rid of the beast and keep it away.

Keep fighting!


chriskaput's picture
Posts: 109
Joined: Jul 2010

Hi Bunny! I was diagnosed in early May with DCIS. Tumor was 2.6cm. I completed 4 rounds of AC and 12 weekly rounds of Taxol. It shrank the tumor as planned to the point where it could no longer be seen or felt! My surgeon even had to put in a "marker" so he would know where to go during surgery.
Well Monday I had my lumpectomy and sentinel node biopsy! I am here resting this week and so happy that all went well! I have a little discomfort but no big deal. No lymph nodes were involved but my doc took out 3. He told me that they were neg. for cancer cells but that they freeze 1 and test it afterwards to be 100% sure. I have not heard back from him yet but have an appt on Tues.
Wishing you the best! You will do just fine just as I have.
I have a fear of the unknown too..the rads. I expect that it will be a breeze though compared to how the chemo kicked my butt!

hugs, Chris

Posts: 1
Joined: Oct 2012

Hi Bunny, I hope you are doing well! Your situation sounds almost identical to mine right now. Chemo was very effective on my breast an lymph tumors! Am now done with chemo and started on herceptin few weeks ago. Oncologist wants me to have surgery to remove any possible remaining cancer cells and remove several axilary lymph nodes. I strongly question the need for surgery since MRI show nothing there except some enlarged lymph nodes. I feel great and am scared of lymphodema after surgery. I Would like to avoid it if it doesnt add to my survival. I was wondering if you went through with surgery and additional treatment and as to what was the findings from what was removed during your surgery.
I would reaaly appreciate your or anyone else's feedback in this regard.
Thank you very much. To your health!

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