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Breast cancer treatment - chemo before surgery
6 Posts
Hi everyone,

I want to thank those who had replied to my first post yesterday, helping to calm my nerves a day before seeing my surgical oncologist.

As mentioned in my previous post, I found out that I have 2 cancer sites on my right breast after going through 2 biopsies and an MRI. At the meeting today, I found out that among the 2 site: I have an IDC with ER+/PR-/HR+, as well as a ILC with ER+/PR-/HR-. The doctor wanted me to start chemo first before surgery due to the HR+ factor. He also wanted a MRI biopsy on my left breast as the MRI images showed some "shades" on the left. On top of that, there will be a CT scan to see if there are any spread to other organs.

I was expecting to learn about lumpectomy and mastectomy, as that seemed to be what everyone had to go through as a first step. So chemo came as a shock. Actually the whole breast cancer thing is still a big shock. Now I have to wait for medical oncologist to contact me about chemo and the treatment will take 3 months when started. Then there will be another MRI follow by surgery etc. I know I'm supposed to feel calmer when I get a treatment plan, but the fact that I have do to 3 months of chemo before surgery appear uncommon and nerve-wrecking. I'm still feeling lost and highly anxious.

Has anyone gone through similar treatments?

Thank you.
7 Replies
99 Posts
Hi SummerHill‍,

The chemo before surgery is surprising when you first hear it! Last year, I went to the surgeon, expecting a discussion about my surgical options and, like you, I was surprised to be told that I would have chemo first (neoadjuvant treatments) because of the HER2+. It’s common to do chemo first for HER2+ breast cancer.

Regarding your comment: “I know I am supposed to feel calmer when I know my treatment plan”. I think it varies from person to person. I was not calmer until treatments had started and I knew the routine. The medical oncologist will outline a treatment plan for you and, in the beginning, it may all sound like a long time and overwhelming. However, once it starts and you get into a routine, it will pass quickly.

The chemo nurses are really great with suggestions for chemo side effects so it has really been very manageable for me. I hope it is for you, too.

There are many helpful online programs at Wellspring:


We will be here for you, too. Be sure to post whenever you need a listening ear.
SummerHill‍ I was diagnosed with HER2+ but it was found out with my surgery which I had done first.

The best advice I can give you about chemo is to hydrate. Drink lots and lots of water. Chemo drugs do a number to the veins. My first treatment (most nervous) was also the longest. They want to monitor you so it takes a little longer. At the second treatment it will be shorter and (it happened with me anyway) the nurse will ask a series of questions based on your side effects. These questions will be asked at the beginning of every treatment except for the first one. You may also get pills to take which will help with the side effects. I made a list and took with me (used a binder) to every treatment what I ate/drank, side effects I experienced, bowel movements and questions I wanted to ask.
Hi SummerHill‍ I had the exact same shock and reaction last week. And am slowly starting to come to terms with this new reality.
I went in for my surgical consultation expecting to talk about a lumpectomy, only to find out what I thought was DCIS, had a secondary tumour and is Triple Negative IDC. The most successful course of action for treating my specific type is to start with chemo, see how the tumors react to it, and then remove whatever is left, followed by spot radiation. Up until that meeting I didn't think Chemo was even on the table. I was ready to lose a breast, totally fine with reconstruction, let's do this!... but I was not at all ready to lose my hair. I was devastated with this news. To be honest, I still am. But I'm working through it. The emotions come in waves. I spent most of rainy Sunday crying, mourning the loss of my hair, the years I will lose of looking my best, and feeling guilty that I'm being this vain and selfish and sad over looks.. I should be happy that I get to go through this treatment so that I get to live. Angry - why is this happening to me?! and Bargaining - If I opt for a mastectomy, can I avoid the chemo??

What I've found helpful is to let myself have that time to cry and mourn, and feel all the hard feelings. I've also been searching through this community, through Instagram, and social media for others going through a similar situation. I have an amazing support system of friends and family so I know I'm not alone. But it's for some reason comforting knowing there are other young women who otherwise would be in their prime going through this life-changing challenge and new reality. Researching wigs, Instagram is great. There are a lot of fantastic international wig makers out there, and they can look pretty amazing. Looking into getting permanent make-up for my eyebrows. Putting a fertility plan into place to freeze my eggs. I can't control my cancer, but I feel more in control when there's a plan. It seems my chemo will now be delayed by 2 weeks for the egg harvesting plan, which gives me some time to get my life in order. Have a conversation with work and what this all means, get fitted for a wig, get my eyebrows done, begin to accept my new reality.

My best friends and I started a group thread where they can check in on me and also see when the others are checking in, so I don't get overwhelmed with people asking me how I'm doing all the time - (I'm doing crap thanks for reminding me...) and they started another group chat to discuss amongst themselves and put plans in place to support me without overwhelming me. One of my friends set this up. The rest were so grateful and shared words of support. I cried. But for a change, they were happy tears.

All we can do is take this one day at a time. Just know that you are not alone and we WILL get through this.
6 Posts
Thank you S2020 for sharing your journey. It is calming to know someone had gone down the same route before and that I'm not alone. I really appreciate it and wish you well in your recovery.
6 Posts
@Buffythevampire, Thank you for sharing your experience. I was so overwhelmed about the chemo treatment and wasn't even able to process and think about handling the side effects. So your post has reminded me to start preparing for it. I am very glad I found this community.
449 Posts
SummerHill‍ you are allowed to feel all that you are feeling. This is tough stuff. I did have surgery first and thought I would have radiation and be done. When I went for my post op follow-up appointment, I was shocked that I was getting referred to the medical oncologist to discuss chemo so can appreciate your feelings about that. I can also relate to the feeling about your hair but for me it wasn't about not looking my best, it was about the fact that I didn't want to look sick. I didn't want to look like a cancer patient. It sounds like you have a terrific network of support set up and I know they will help carry you through as will this community.
12 Posts
SummerHill I had the same bio markers as you for my IDC. ER+ PR- HER2+. I did neoadjuvant chemo for 6 cycles consisting of 2 targeted therapies and 2 cytotoxics (Pertuzumab trastuzumab DOCEtaxel CARBOplatin). This took me to Nov 3rd 2020 and I had a left mastectomy with immediate autologous reconstruction Dec 18th. The chemo fatigue typically sets in about 7-10 days after your chemo cycle when your nadir for your neutrophils is the lowest. You have many more good days than bad and knowing you have an end in site is helpful. The anti emetics for nauseau are a godsend. Your appetite will be impacted depending on what treatment you are on, some make food taste rather metallic but you will learn what agrees with you and what does not. It’s a marathon not a sprint, you truly have to take it one day at a time, baby steps, and remember there are always better days ahead when you are feeling at your lowest. You will be amazed by your resiliency! I lost my hair and most of my eyelashes and bit of the brows. They are filling back in and my hair is coming back same shade, similar texture but with a bit more density which is great cause I’ve always had fine thin hair. It’s also taking on a bit of a fauxhawk pixie style and I’m embracing it. I did get a wig but with covid I rarely left the house so it mostly sat in my closet. I used the American cancer society pages for a side effect tracker. It’s very helpful as it breaks everything up into different groups such as fatigue, GI toxicities etc. I recommend charting everything as you will forget to chat with the doc or nurses about some of the things if you don’t write them down. My employer and my team were remarkable, I went on medical leave and am still off but stay in close touch with my colleagues. Sending positive thoughts.
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