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A MyBCTeam Member asked a question 💭
Los Angeles, CA

I have another question. I have been diagnosed with TNBC. My tumors are small enough to do the lumpectomy. However one surgeon is recommending I do chemo before the surgery. Another surgeon recommended I do chemo after . Can someone shed some light on the difference

July 25, 2025
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A MyBCTeam Member

I would do before surgery without a doubt.
1. You have to completely heal from surgery before surgery. What if you have a complication, and chemo gets pushed out? That allows more time for this to spread.
2. If you do chemo first, surgery tests the chemo. My surgical pathology showed the chemo killed the cancer in my breast. If it killed it there, it also should have gotten any cells that may have gotten out if the breast, but not big enough to show on the MRI.
3. Standard of care for TNBC Neo adjuvant chemotherapy is Taxol Carboplatin Pembrolizumab weekly times 12, followed by Adriamycin Cytoxan Pembro every 3 weeks times 4. If you surgery first, Carbo and Pembro would be omitted. Pembro is immunotherapy for TNBC. If I have to get chemo, I want standard of care, and the best possible chances for survival.
When in doubt, never a bad idea to get a second opinion. I did not for oncologist, because I researched it, and I was getting standard of care. I was unsure about surgery, so I did do a second opinion.
Wishing you well!

July 25, 2025
MyBCTeam

Both approaches - getting chemotherapy before surgery (neoadjuvant) or after surgery (adjuvant) - can be effective for TNBC. The timing often depends on specific factors about your cancer.

Neoadjuvant chemotherapy (before surgery)
- Helps shrink tumors before removal
- Can improve overall prognosis for TNBC
- Gives extra Show Full Answer

Both approaches - getting chemotherapy before surgery (neoadjuvant) or after surgery (adjuvant) - can be effective for TNBC. The timing often depends on specific factors about your cancer.

Neoadjuvant chemotherapy (before surgery):
- Helps shrink tumors before removal
- Can improve overall prognosis for TNBC
- Gives extra time to plan breast reconstruction or get genetic testing
- May make surgery easier to perform Adjuvant chemotherapy (after surgery):
- Kills any remaining cancer cells that might be left behind
- Helps prevent new tumors from forming
- Reduces the chance of cancer returning

Since your tumors are small enough for lumpectomy, either approach could work. This is a decision best made through detailed discussion with your medical team who can consider all aspects of your specific case.

July 25, 2025

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A MyBCTeam Member asked a question 💭
Los Angeles, CA