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Neoadjuvant chemo

Gemma12 Member Posts: 100

So after my core biopsy, I thought I had 1.4CM mixed IDC/ILC ++- tumor but after receiving my MRI results it seems like there is more extensive disease. From my path report;" Additionally within the left breast there is marked abnormal mass and nonmass enhancement involving all 4 quadrants of the left breast". "Collectively the regions of abnormal enhancement appear to encompass all 4 quadrants as well as the nipple areolar complex. The maximal extent of appears to measure approximately 7.7 cm"

Although the new stuff hasn't been biopsied, my BS feels like it's DCIS. She's tried to call the Radiologist that read the report but they had left for the day. She'll try again tomorrow. I wasn't going to do any more biopsies because I'm having a mastectomy. So they wouldn't change my surgical decision. This is the 2nd time I've had cancer in this breast. It's not a recurrence but a new primary cancer. I had a lumpectomy and radiation followed by tamoxifen.

BS is worried that she won't be able to get clean margins and won't be able to re-radiate the area. She asked me to reach out to my MO and get his thoughts on neoadjuvant chemo. I'm wondering if anyone else walked this path could share with me the length of their neoadjuvant therapy.


  • elainetherese
    elainetherese Member Posts: 1,625


    I did neoadjuvant chemo from mid-July 2014 until mid-December 2014. So, that's about five months. I took this path because 1) my tumor was big (5 cm + lovely satellite tumor); and 2) I was triple positive (at the time, it was easier to get Perjeta as part of the chemo cocktail if you did neoadjuvant chemo).

    But...most of my cancer was invasive, and neoadjuvant chemo was partly an attempt to shrink my tumor. (By the way, it completely wiped out the cancer in my affected breast and compromised node so I ended up with a lumpectomy rather than a mastectomy.)

    I expect they haven't run the Oncotype Test yet to see whether or not your cancer would benefit from chemo. Were you going to do chemo anyways? One advantage of neoadjuvant chemo is you can see whether or not it works on your particular kind of cancer.

  • Gemma12
    Gemma12 Member Posts: 100

    HI, Thank you for the reply. I have to have a mastectomy as I already had a lumpectomy and radiation on that breast. My MO told me that he'd only recomend chemo if I had 4 nodes + and a high Onco score. My Onco score on my cancer I had 7 years ago was 18, and I was hoping for the same result with this cancer. I'll do the chemo if they tell me I should, but would rather not. ;). Especially if my BS can get clean margins and I have no nodes +.

    I'm glad the neoadjuvant chemo wiped out all your cancer!

  • elainetherese
    elainetherese Member Posts: 1,625

    I'd wait for the Oncotype Test if I were you. There's no sense in doing the chemo if you don't have to. With triple positive, chemo is a given. But, since you're ER+, you can always do hormonal therapy as a systemic treatment. Heck, I'm still doing hormonal therapy, eight years down the line.....