Chemo before or after surgery

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I am to believe the treatment for TN is have chemo first so I was referred to an oncologist. I am 71 and in spite of having diabetes and heart disease I am pretty fit. My cardiologist cleared me to have chemo so I surprised that the oncologist said having chemo wasn’t worth the risk and I should have surgery and have to accept something is going to get you sooner or later.

I returned to my breast surgeon and I am to have a lumpectomy in few days time but what I have after remains to be seen.

I feel the oncologist was writing me off because of my age. I appreciate no one lives forever and being diagnosed with TN I am a lot near to the end of life than many suffers of TN as it mainly affects younger women but I still I want the best shot of living and living well for as long as possible.

I have told my surgeon I don’t wish to see this particular oncologist again as we are not on the same page and in future I want to see someone else which I can easily do as I am having private treatment and my breast surgeon agrees. However I am worried I having surgery in the wrong order and I am not getting the optimum treatment.

  • Hi I know of a few people on the forum who had lumpectomy first me included. Think it’s often in that order when it’s early stage with no spread to nodes. 

  • I have also had surgery first for an early stage TNBC with no evidence of spread. I am a little younger than you and am not at all convinced that the benefits of chemo outweigh the risks. I don’t think there’s a one size fits all here, it’s very much about your own pathology in the wider context of your general health and personal preferences. I doubt if the oncologist is writing you off, but is looking at quality of life in view of your absolute recurrence risk and the reduction in risk chemo might generate.