Hi Kathy, HER2+ gal here (IDC, Stage 2, Grade 2, one tumor 2.7 cm, clear lymph nodes).

When I met with the surgeon, I was told I was a candidate for either lumpectomy or mastectomy. My chemo schedule would be determined by what I chose. If I chose lumpectomy, we would do chemo first to try to shrink the tumor as much as possible, so that the surgery would not require taking as much tissue. If I chose mastectomy, we could do surgery first, then chemo.

Keeping you in prayers as you navigate all the info to make the choices that are right for you! Hugs!

@A MyBCTeam Member
LauraAh have a good explanation.

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A MyBCTea...

Thank you that helps

Standard of care, chemo first unless tumor is small, under 1 cm.
Some concerns with having surgery first. Chemo has to be giving within a certain time frame. If there are healing issues, chemo has to be delayed. If one is not fully healed in that time frame, chemo cannot be given, the benefit is lost. Her2 is aggressive, recurrence is a concern.
Also, the treatment changes. If surgery first, treatment is Taxol Herceptin. If chemo first, Carboplatin and Perjecta are added to the Taxol and Herceptin. Plus, surgery tests the chemo. If there is any residual cancer found after surgery, there are other medications that can be given to reduce recurrence, Kadcyla, Neratinib. If surgery is first, you wouldn’t know if chemo killed every thing.
No one wants chemo, but if I had to have, I would choose before surgery.
Wishing you well!

When my mom was diagnosed with HR and HER2 stage 4 invasive lobular breast cancer with mets to her hip bones in 2006 her first treatment was a single mastectomy. After that she had chemo followed by radiation. When that was all done she had her reconstructive surgery with the lat flap. After that she was on a series of different drugs which would be switched up as her cancer continued to spread to new locations.