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Neoadjuvant vs adjuvant treatment for local recurrence triple positive

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Hi, everyone — I've just been diagnosed with a local recurrence of my original breast cancer — in 3 axillary lymph nodes. Petscan indicates no other cancer. ER+ PR+ HER2+ My original breast cancer was diagnosed in November of 2014.

I am the kind of person who wants it out now and that's what I did originally - with bilateral mastectomies. I'm being told now that the decision is different because of the lymph node location?

Lastly — I know that chemo is awful — first round, I was supposed to take 12 weekly treatments of taxol (adjuvant treatment) with herceptin. I only made 9 weeks before my body revolted but finished the herceptin. I did 4.5 years of AI — trying anestrozole, exemestane and tamoxifen. I am almost 69 years old. My natural lifespan is only an estimated 12 more years. Why do I have to have chemo for this recurrence? Why can't I have herceptin (or it's modern day equivalent) and take exemestane, or something like it? After the first cancer, the treatments left me with ruined joints and bones — 5 joint replacements, cirrohsis of the liver and more arthritis than my mother, my grandmother, and my great-grandmother ever had — and I can't even take ibuprofen for it because of the liver.

My meeting with the oncologist is August 2nd. I am researching as fast and I can — any comments, experiences or research that you feel like sharing — I will appreciate it greatly. Thank you.