After 5 chemo sessions great improvement tumor reduced by half and no lymph nodes...but?

Question

It seems that my wife's oncologist was right on target to combat the tumor found in her breast. I am so happy! She still has a long road ahead of her, but what I don't understand is that if her cancer was not evident after all her chemo treatments they would still do surgery because they go by the first diagnosed stage.

Before the treatment two lymph nodes were positive but now none are positive. I am so glad! God is answering my prayers.

If cancer was not evident by testing after all chemo treatments what harm could be done if she did not lose a breast?

They say they cannot tell on a cellular level if any cancer is still there, why not?

I am a little confused but glad her treatment seems to be going well.

Answer 1

I am so happy for you guys... I know all of this is confusing.  There is really no way to tell if the cancer is COMPLETELY gone from your wife's breast since it existed there at one point in time... think of it as wearing down the breast tissue, or altering the tissue on a cellular level that would not be apparent to the naked eye, but leave her more vulnerable for relapse.  If they take the breast, the "diseased" organ is gone, and has no possible chance to "re-infect"  the body as a whole.  It is "tainted" by the cancer and poses a life-threatening risk to your wife if it were to remain, even if the chance is slim.  

I hope that helps... you are so sweet to want to understand the "why" for your wife.  She is lucky to have your support!!  Lots of hugs for you guys!

Answer 2

Dave, chemo agents work on cancer cells that are at a certain stage of activity. Typically, the target cells that are rapidly dividing (since this is typical behavior of cancer cells). However, not all tumor cells are rapidly dividing all the time. So chemo may not kill them.

PET scans and such can only pick up clusters of tumor cells that reach in the millions of cells. Size being about 5 mm.

Surgeons open the breast and cut away the tumor site. They cut a margin of tissue around the site, and the margin is examined microscopically. If no cancer cells are found, the margins are called "clear" and the cutting is done.

But no one, no one in their right mind, believes that all the cancer cells are gone.

They do surgery not because of staging, but because surgery is the primary tool in eliminating the cancer. Chemo is adjuvant therapy. So is radiation. She doesn't necessarily have to lose a breast ... lumpectomy + radiation has recurrence rates as low as mastectomy. You should discuss this with her surgeon.

But trust me ... you don't want to leave any cancer cells behind. You have to hit this disease with the whole arsenal. Because often if it comes back, it comes back with a vengeance.

Answer 3

It's great that the chemo has worked so well.  One reason that chemo is given prior to surgery is to reduce the size of the tumor and reduce the incidence of lymph node involvement.  It is wise to remove the affected breast, because, even though the tumor is not evident on a mammogram, it was there,and may still have cancer cells.  I understand your question, but, if you look at this from a cellular level, you would have to examine each cell.  Breast cancer causes many deaths every year, even in men. You have been patient and supportive for your wife, which, will do her more good than anything she's been through so far.  May the Lord be with you both and enable the healing process.