Chemo first?

I found out my aunt was diagnosed with breast cancer this past Friday.  She got the biospy results today and I have not heard full disclosure of results, but just heard that they will likely do chemo and radiation therapy before they do a mastectomy.  I want to know why they would decide to do chemo first?  

[Fernando Roque, MD]

Hi.  Sometimes the breast tumor is initially unresectable but may be judged by the surgeon as potentially operable if its size can be reduced.  In these cases, chemotherapy is done first (this procedure is called neoadjuvant chemotherapy) in an attempt to reduce the size of the tumor and make it operable.  It's also possible that the tumor is resectable, but the surgeon just wants to reduce the size of the mass further before operating, so that the resulting surgery would be less extensive and less morbid.