Sunday, September 13, 2009 zahia asks

Q: What is the difference between Neoadjuvant treatment and adjuvant treatment ?

On the August 12 , 2009 I was diagnosied with a Suspicious mass in my right breast

I did a biopsy the 28 August 2009 , and till now I didn't bigin my treatment.

So I have ,

-- DUCTAL INVASIVE CARCINOMA, Nuclear GRADE 3/3(E CADHERIN positive)

IN-SITU DUCTAL CARCINOMA COMPONENT NOTED, Nuclear GRADE 3/3

WITH CENTRAL COMEDO-TYPE NECROSIS.

-- SURROUNDING BREAST SHOWS CHANGES CONSISTENT WITH PSEUDOANGIOMATOUS

STROMAL HYPERPLASIA, COLUMNAR CELL CHANGES AND MILD CYSTIC CHANGES.

-- Also, I have ER POSITIVE with % of cells positive: 95 -

Staining intensity :moderate and strong

Antibody used : SP1

ER POSITIVE with % of cells positive: up to 10-

Staining intensity : weak, moderate and strong

Antibody used : 1E2

HER2/neu Protein : NEGATIVE

Score : 0

Antibody used : 4B5

My Doctor for surgery suggested two treatment options, neoadjuvant or adjuvant.

My rumor is in my right breast, and is 20 mm X 16 MM , can anybody help me about

what are the risks and benefits between the two options ? I know that my surgeon

want to shrink the tumor, but is this the best way to get rid of it ? and how many

times I will go through the chimiotherapy treatment ? does anybody know about someone

who did the same treatment ( I mean Neoadjuvant treatment ) ?

. Can you tell me the difference and the risk factors about them ?

Thanks for you help

zahia

Answers (2)

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PJ Hamel

9/13/09 10:01pm

Hi - Neoadjuvant and adjuvant simply refer to "before surgery" and "after surgery." Neoadjuvant treatment means chemo before surgery; adjuvant means chemo after surgery. Studies have shown various results for giving chemo before vs. after surgery; so at this point it's inconclusive whether one or the other is better. If I were you, I'd trust my oncologist's decision. If s/he wants you to do chemo prior to surgery, to shrink the tumor and make the surgery easier/more effective - why not do it?

As for what chemo will be like, this is a question for your doctor. It'll be based on all the details of your pathology report, and the doctor's best guess as to what will work well, drug-wise and schedule-wise. So best to ask him/her, OK? Good luck - PJH

Phyllis Johnson

9/14/09 5:29am

I had chemo both before and after surgery. I agree with PJ that it's best to go with your oncologist's recommendation for a technical treatment issue like this. A huge advantage of the neoadjuvant chemo is that the doctor and you can actually see the tumor shrink (or not) so that you know whether the chemo is working and switch to a different drug if it is not. Chemo before surgery is used to shrink the tumor to make surgery easier, and to kill any cancer cells already wandering around your body in situations where the doctor is concerned that tumor cells may have spread.

Q: What is the difference between Neoadjuvant treatment and adjuvant treatment ?

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