Halfway Check-in: Surgery Planning Starts

Mid-chemo appointments can feel like standing on a bridge: you’re not at the start anymore, but you’re definitely not at the end.

On 18 February 2026, I saw my breast surgeon for a follow-up consultation. The point of the appointment was to look at how treatment was going and start shaping the surgical plan.

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What we already knew from scans

The mid-treatment ultrasound measurements were moving the right way:

• Main tumour had reduced to 14 × 14 × 14 mm (previously 19 × 14 × 15 mm)
• Marked axillary node had reduced to 11 × 5 mm (previously 13 × 8 mm)
• No other abnormal axillary nodes were seen

That “trend” matters, because it’s what gives you confidence that the months of chemo are doing their job.

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The big surgical headline: the axilla

Even with a good imaging response, the surgeon was very clear about one thing:

Because of the extent of lymph node involvement at diagnosis (an N3 presentation), I will still need an axillary clearance at the end of chemotherapy.

This is one of those moments where you realise response is only part of the story — the starting point (how extensive it was at diagnosis) affects what has to happen next.

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Breast surgery: what we’re aiming for

The plan discussed was to aim for breast-conserving therapy (rather than mastectomy), depending on the final scans at the end of chemo and what’s safest/clearest at the time of surgery.

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The practical risk talk: lymphoedema

We also discussed the risk of breast cancer–related lymphoedema after axillary clearance (quoted around 20–30%).

It’s not an abstract risk — it’s something you need to understand early so you can recognise signs, reduce risk where possible, and get help quickly if it starts.

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Next steps

The plan was to:

• Finish chemotherapy (with an expected end date in late April)
• Have end-of-treatment imaging (MRI, mammogram, ultrasound)
• Then move into surgery planning and proceed to operation in the following weeks