milestone 🌟

Chemo Finished. Surgery Next.

After months of treatment (EC then weekly Taxol) alongside Phesgo, imaging now shows very little enhancement where the cancer was, and previously abnormal lymph nodes look normal. With a good response and reassuring heart checks, the next step is surgery in May.

Chemo Finished. Surgery Next.

It’s been a while since the site was updated, but a lot has happened since November.

This is the “where we are now” moment: chemo is done, the scans look very encouraging, my heart checks have been reassuring, and the next stage is surgery.

The diagnosis we started with (November 2025)

Back at the beginning, the picture was clear and scary:

  • Right breast invasive ductal carcinoma (IDC), Grade 3
  • ER 0 / PR 0 (hormone receptor negative)
  • HER2 3+ (HER2-positive)
  • Lymph node involvement on biopsy
  • PET/CT showed no distant disease, but there was a lot of local lymph node involvement (axilla/subpectoral area, and up towards the lower neck).

We also did genetic testing, and no germline mutation was identified.

The treatment plan

The plan was always in phases:

  1. Dose-dense EC x4
  2. Weekly Taxol x12
  3. Phesgo throughout, continuing after chemo
  4. Surgery (breast + axilla), then radiotherapy
  5. Further HER2 treatment depending on what surgery pathology shows

Because HER2 treatment (and EC) can affect the heart, the cardiac side of things mattered too. I had cardiology review and regular echocardiograms, and I started atorvastatin 40 mg.

How treatment response has looked on scans

One of the hardest parts of this whole process is the waiting between scans, trying not to read too much into every sensation. But the imaging trend has been a steady move in the right direction.

Ultrasound updates during chemo

  • 23 Dec 2025: good response in the axilla; more modest change in the breast overall size/extent
  • 22 Jan 2026: the breast mass measured smaller, and the marked lymph node measured smaller; no other abnormal nodes seen
  • 4 Mar 2026: right axilla showed no axillary adenopathy

MRI (April 2026)

The most recent breast MRI shows very little enhancement where the cancer was, and the nodes appear normal.

That phrase — “very little enhancement” — is the kind of thing you cling to after months of treatment. It doesn’t confirm pCR on its own (only surgery pathology can do that), but it’s as encouraging as imaging gets.

Chemo finished, Phesgo continues

  • Last chemo: 24 April 2026
  • Single-agent Phesgo: continuing (including early May)

And the heart checks have been satisfactory, including the April echocardiogram review.

Next step: surgery (May 2026)

On the phone (29 April 2026), my oncologist confirmed the plan to move to surgery now that chemotherapy is complete.

Surgery is the next big milestone because it gives the definitive answer:

  • Was there a pathological complete response (pCR)?
  • If not, how much (if any) residual disease is left, and what does that mean for the next HER2 treatment steps?

For now, I’m holding onto the headline: the imaging response has been very good, and we’re moving forward.