Topic: Neoadjudvant Chemo no surgery needed
- Posted on: Nov 4, 2009 09:15 pm
Posts: 9
I completed 6 rounds of TAC chemo on Oct. 30th, 2009. My oncologist said that they are going to schedule a PET scan in a couple of weeks and depending on the results, there may not be need for surgery or radiation? Question: Has anyone else had Neoadjuvant Chemo and not had to have surgery because of a Complete Clinical Response? Thanks.
Diagnosis: 6/9/2009, IDC, 2cm, Stage IIIb, Grade 2, ER+/PR+
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Toronto_012… Joined: Nov 2008 Posts: 45 |
Nov 4, 2009 09:38 pm
Toronto_012 wrote:
Hi, I had neo-adjuvant chemo and was told that they always operate to take the site of the tumour out. Toronto |
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Estepp Joined: Jun 2008 Posts: 3,796 |
Nov 4, 2009 10:12 pm
Estepp wrote:
I had that response.. FULL response to Chemo.. it was unbelievable news... If they do not do surgery... how do they know ANYTHING after Chemo... ? Rads might not be needed.. but some type of surgery IS IS IS... PM me if you wanna chat about it.. ok? Laura We are the Ta Ta Sisterhood! Her2+ BC is what I had.... and yes sisters.. I had lymph node involvment... DX 6/25/08 www.estepps.blogspot.com
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lexislove Joined: Sep 2007 Posts: 1,942 |
Nov 4, 2009 10:47 pm
lexislove wrote:
Rads may not be needed...but surgery definatly. Some woman are able to have a lumpectomy after neoadjuvant chemo. Also...scans are not all that reliable.Just ask a few woman on here who have done the neo adjuvant route. The surgery is the time when the docs know for sure just how well the chemo worked. Dx: Sep 2007, IDC 8cm, 0/6 nodes, ACT Chemo, R Mastectomy, 1 yr Herceptin, 28 Rads,Currently on Lupron, Tamox & Zometa. Exchange Sx Fall 2009, BRCA -
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Gitane Joined: Feb 2008 Posts: 829 |
Nov 4, 2009 11:05 pm
Gitane wrote:
From my MRI after neoadjuvant chemo I may have had a pCR, but after the mastectomy the pathologist could see viable cancer still in the breast. I'm not sure anything short of surgery can assure you of a pCR, even if the surgery is a lumpectomy of the former tumor site. For this reason a clip is often placed in the tumor before neoadjuvant therapy, so the surgeon will know exactly the site of the tumor if it disappears. Dx 8/18/05, Pleomorphic ILC, multifocal, multicentric, G2, 1/9 nodes positive, OncotypeDX 23, ER+ PR- Her2-
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KerryMac Joined: Jan 2009 Posts: 1,699 |
Nov 5, 2009 08:08 am
KerryMac wrote:
I have read of too many women who thought they had a complete response, only to find cancer still present after surgery. If it was me, I would still want surgery. Kerry - Mx, Chemo, Rads, Ooph, Arimidex, Zometa
Diagnosis: 11/2008, IDC, 6cm+, Stage IIIa, Grade 3, 6/11 nodes, ER+/PR+, HER2- |
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DCMom Joined: Mar 2008 Posts: 152 |
Nov 5, 2009 09:20 am
DCMom wrote:
DITTO-Throw everything you can at it now because this is the best time to stop it in its tracks. Boobs are overrated when your talking about certainty of a complete response. I would much rather say I didn't need to than oh my gosh I should have. Congratulations on a great chemo response! At least you know it responded and you are WAY ahead in the game. I have called upon you, for you will hear me oh God! Psalm 17:6
Diagnosis: 1/17/2008, IDC, 3cm, Stage IIIa, Grade 2, 4/13 nodes, ER+/PR+, HER2- |
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KerryMac Joined: Jan 2009 Posts: 1,699 |
Nov 5, 2009 09:23 am
KerryMac wrote:
Yep, the way I see it, it is a one shot deal. Do everything you can, have no regrets.... Kerry - Mx, Chemo, Rads, Ooph, Arimidex, Zometa
Diagnosis: 11/2008, IDC, 6cm+, Stage IIIa, Grade 3, 6/11 nodes, ER+/PR+, HER2- |
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NancyD Joined: Feb 2008 Posts: 2,195 |
Nov 5, 2009 09:25 am
NancyD wrote:
Chemo may show a complete response via MRI, but it cannot see the microscopic cells that can remain and continue to grow back. Removal of the tumour site is the minimum you would need (lumpectomy), along with a pathological examination. Quite often, the path report still shows a small amount of active tumour cells. I'm not a complete idiot. Some parts are missing.
Diagnosis: 2/28/2008, IDC, Stage IIIa, Grade 2, 4/10 nodes, ER+/PR+, HER2- |
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mumayan Joined: May 2008 Posts: 1,304 |
Nov 5, 2009 09:26 am
mumayan wrote:
I had a complete response to chemo but still had a mast. Diagnosis: 4/23/2008, IDC, 5cm, Stage IIb, Grade 3, 2/15 nodes, ER+/PR-, HER2- |
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SherriG Joined: Jan 2005 Posts: 4,861 |
Nov 5, 2009 10:04 am
SherriG wrote:
The others are right about surgery. As far as rads, even with a complete response, if you have/had positive nodes, then radiation is needed to clean up any stray cells in the area. I think the cutoff for rads to the axilla is 2+ nodes. Anything over two and you need rads. Hope this helps. Diagnosed 11/05/04 Stage 3 ILC "Lump is a four letter word!" Sherri
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TammyLou Joined: Dec 2006 Posts: 572 |
Nov 7, 2009 07:59 pm, edited Nov 7, 2009 08:02 PM
by TammyLou
TammyLou wrote:
I sure would want a second opinion on that. There is a WAY big difference between clinical response and what is ACTUAL. (Take it from the women who had all clean imaging...yet, still had cancer present when they were opened up.) Stage 3C for me...RADS (in 6 fields with 2 sets of boosts) followed pathologically complete response (NO cancer present after chemo determined by surgical excision). If I was you, chickie...I would want a well-known major cancer treatment center to confirm the integrity of that "plan"...unless you are 100 years old and/or have some kind of other major health problem (cardiac or diabetes) that may cause "issues" with tolerating rads. tl |
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Faith316 Joined: Jul 2009 Posts: 153 |
Nov 7, 2009 09:19 pm
Faith316 wrote:
A PET/CT will not show anything until there are something like a billion cells present or a centimeter. I had another clean scan the other day. But, although my onc. thinks I may have finally had a complete clinical response, he says there is no way to see micromets that are too small. Either way, i'm celebrating the clean scan. Not gonna borrow trouble. DX 4/08 IDC, ER-, PR-, HER2+, Stage IIB, Grade 3, lumpectomy, 2/8 nodes, 4 AC, 12 wks. Taxol, Herceptin, 30 rads., DX with IBC in 6/09 while still in active treatment. Now Stage III. Currently on Xeloda, Tykerb. Surgery to follow.
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karen1959 Joined: Jul 2009 Posts: 138 |
Nov 8, 2009 06:29 pm
karen1959 wrote:
I would do more research to satisfy yourself. This is your body, you will live with the decision you make and hopefully, with no regret. When God is not walking along with you, he is carrying you
Diagnosis: 6/2009, IDC, 5cm, Stage IIIa, Grade 3, 0/1 nodes, ER+/PR+, HER2- |
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JacquelineG… Joined: Jan 2009 Posts: 96 |
Nov 12, 2009 09:21 am
JacquelineG wrote:
Hi precioustime, Like you, I had a PET/CT after chemo which showed no more cancer in IM node (i had mastectomy and node dissection prior to chemo). I still had radiation in 6 fields and am convinced the benefits outweigh the risks (at least for me) being a stage 3! didn't want to take any chances. Let us know how your PET goes! Jackie Diagnosis: 6/2/2008, IDC, 2cm, Stage IIIc, Grade 3, 6/40 nodes, ER+/PR-, HER2- |
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LJ13-2 Joined: Mar 2009 Posts: 93 |
Nov 12, 2009 11:28 am
LJ13-2 wrote:
OMG. I would seriously consider a different doctor if he said that. It takes about a billion cancer cells aggregated to show up on a PET scan. The tumor bed must be removed. |
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skimmingthe… Joined: Oct 2008 Posts: 48 |
Nov 12, 2009 12:14 pm, edited Nov 12, 2009 01:46 PM
by skimmingthelake
skimmingthelake wrote:
I too had a complete clinical response with fully negative mammo, MRI, and gamma, and was FIGHTING mad when my onco team insisted I have a mastectomy with full lymph node removal. Why would I want to do that?, I thought. I ended up having it done, however, and path came back clean, clean, clean, so there was NO cancer in me after chemo. I followed it with the max rounds of rads. I was still mad about the mast until my onc explained that I still had a 30-50 percent chance of recurrence (WHAT????) because of my stage (IIIa) and grade (2-3) of tumor. Once I got this into my thick skull, I then opted for a prophy mast on my "good" side (during my bilateral DIEP reconstruction last month) and the path report for that breast was also fully clean. (((I close my eyes and raise them to heaven in thanks.)) Until the docs figure out a way to be close to 100 percent sure that the cancer is gone, the standard of treatment is still to take the breast and examine it microscopically ... although in many cases it turns out to be a perfectly clean healthy breast. Now because of the choices I've made so far, supposedly, there is only a miniscule chance I can get a recurrence of BC in the breast areas because I have no breast tissue left ... my new "breasts" have been made from my abdominal tissue. I could get it elsewhere, however, if it decides to pop up, say, in the lungs or bones. I just don't want to even go there.... All my best to you, precioustime, as you decide Gayle (formerly gayleeee) IDC: ER-/PR-/HER2+; BRCA-; clinical Dx 8-8-08 Stage IIIa: 5-6cm mass w/2 pos nodes. Neoadjuvant chemo (TCH) 9-12/08: CR 12/08. Left MRM w/all (23) nodes 1/09; NED. 33 rads 4/09; Herceptin thru 8/09. Recon Oct '09.
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precioustim… Joined: Aug 2009 Posts: 9 |
Nov 19, 2009 02:30 pm
precioustime wrote:
Thank you Ladies! Maybe the reason the Oncologist was not sure if surgery or radiation was going to be needed -- was because they had biopsied 1 mediastinal lymph node (in chest) and it was positive. Her thought was why take the breast if there is cancer in inoperable lymph node. This was reason for neoadjudvant Chemo. I believe she wants to see the results from PET scan and mammogram before going to Oncologist/Surgeon board to discuss my case? I definitely agree with your comments on throwing everything at it! At this point I am waiting to see the Oncologist 10/30/09 and hopefully will have a game plan by then. The waiting is always the hardest part... Diagnosis: 6/9/2009, IDC, 2cm, Stage IIIb, Grade 2, ER+/PR+ |
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TammyLou Joined: Dec 2006 Posts: 572 |
Nov 19, 2009 03:54 pm, edited Nov 19, 2009 03:55 PM
by TammyLou
TammyLou wrote:
I'm glad you explained about the positive mediastinal node. In that case, what your doctor is suggesting makes logical sense to me. Please let us know what the cancer board says. tl |
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Colette37 Joined: Apr 2009 Posts: 147 |
Nov 19, 2009 09:22 pm
Colette37 wrote:
I had 6 treatments of chemo before bilateral masectomies done. The big thing about that is I did not have any IDC left, but I still had a 10 cm DCIS tumor! They did an MRI right before the surgery and there was nothing which showed up, and I did not feel any lump left after the chemo had started working. Chemo kills fast growing cells, but does not kill the slow growing DCIS. Colette
Diagnosis: 3/17/2009, IDC, 6cm+, Stage IIIb, Grade 3, 0/10 nodes, ER+/PR-, HER2+ |
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mumayan Joined: May 2008 Posts: 1,304 |
Nov 19, 2009 09:26 pm
mumayan wrote:
I had a complete response to chemo.Then had a mast to be sure.Recently had a second mast. Pathology is now clear. Do all that you can to be safe. Diagnosis: 4/23/2008, IDC, 5cm, Stage IIb, Grade 3, 2/15 nodes, ER+/PR-, HER2- |
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