CommunitiesIn Treatment For Breast CancerHas anyone had hormone therapy or chemo before breast cancer surgery?

Has anyone had hormone therapy or chemo before breast cancer surgery?

KC

Community Member

7 months ago

Has anyone had hormone therapy prior to surgery? Also curious about chemo before surgery? I have what they believe is Stage 2A IDC PR+, ER+, HER2-, grade 3, Ki-67 is 37%, waiting on Oncotype Dx and also on genetic testing results. I have very dense breast tissue. They are basing what they think my stage is off of my MRI results. I found a lump on February 19, couldn't get in for a diagnostic mammogram and ultrasound for almost until March 17. Then, they had another 2 weeks before they could get me in for a needle biopsy. At that time I had some questionable lymph nodes, but the decided not to do a needle biopsy on them because they are so small. I was then scheduled for breast MRI on April 14 and surgery consult that week. My surgeon set me up to have a lumpectomy and sentinel node biopsy done last Thursday. The day of the surgery it was canceled by The Tumor board, who discussed my case and decided that it would be better to try chemo prior to surgery to shrink the cancer first. They realized that the MRI is showing the cancer is almost a centimeter larger than they first saw on my Ultrasound. I met with medical oncology and they need my oncotype Dx, my genetic blood test, and lymph nodes biopsy results before they can determine if chemo will be effective for me. I have asked several times about starting hormone therapy because my cancer is strongly hormone positive and I am still pre-menopausal. All the doctors don't see this as being beneficial. So, nothing has been done yet to treat my cancer. I now have to go for a needle biopsy of the lymph nodes and wait for other test results to come back. They sent my original needle biopsy for oncotype. It seems like they are saying that the MRI measured the cancer differently, no one seems to think it could have grown that much in a month. Yet I keep being told that it is a more aggressive hormone positive cancer (grade 4 and the Ki67 score of 37%). It is going 3 months since I found the lump. They originally said it was around 2 centimeters, now they are saying it is 3 centimeters. They may also be a second lesion they didn't originally see. They are going to try to biopsy it as well. Should I just tell them to do a mastectomy and be done? They had given me the option of a lumpectomy. I still don't understand why none of my doctors do not see hormone therapy as a current option. I understand why it is done after surgery and radiation, but why can't we try to slow the cancer down now? Sorry for the long post.

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accepted answer

Accepted Answer

Many community members have shared experiences with neoadjuvant therapy (treatment before surgery), including both chemotherapy and hormone therapy, though the specific approach varies greatly based on individual cancer characteristics and medical team recommendations. The waiting period for test results can feel incredibly frustrating, especially when dealing with questions about treatment timing and approach. Your medical team's decision to wait for the Oncotype DX, genetic testing, and lymph node biopsy results before finalizing a treatment plan is quite common, as these results help determine the most effective treatment sequence for your specific situation. Consider writing down all your questions about hormone therapy timing and treatment options to discuss thoroughly with your oncologist - many find it helpful to bring a support person to appointments to help remember the discussion points.

3+ patients found this helpful

DE

Community Member

6 months ago

I'm sorry they're slow walking you like this. That doesn't seem right. It must be frustrating. My surgeon told me that size estimates from MRI tend to be bigger than from ultrasound. I'm confused on how they can wait for oncotype results before starting chemo of they want to do it before surgery. My doctor said you need a bigger sample than what they get from the needle biopsy for that. Can you go somewhere else for a second opinion?

1
KC

Community Member

6 months ago

I got a second surgical consult, but not a second medical oncology consult. I am seeing a different medical oncologist than the one that my surgeon meets with on her tumor board. Mostly because my surgeon is about 2 hours away and we have a good medical oncology group about 15 minutes away from where I live. It is still the same health system, so they are coordinating care, but if I don't have to travel 2 hours for chemo for several months, then I would like to avoid that. One oncologist was ready to start chemotherapy, the other says we need more information. It is helpful to know that MRI's tend to measure larger than ultrasounds. My mammogram was very difficult for radiology to read because of my dense breast tissue.

CA

Community Member

2 months ago

Many community members have shared experiences with neoadjuvant therapy (treatment before surgery), including both chemotherapy and hormone therapy, though the specific approach varies greatly based on individual cancer characteristics and medical team recommendations. The waiting period for test results can feel incredibly frustrating, especially when dealing with questions about treatment timing and approach. Your medical team's decision to wait for the Oncotype DX, genetic testing, and lymph node biopsy results before finalizing a treatment plan is quite common, as these results help determine the most effective treatment sequence for your specific situation. Consider writing down all your questions about hormone therapy timing and treatment options to discuss thoroughly with your oncologist - many find it helpful to bring a support person to appointments to help remember the discussion points.

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