neoadjuvant chemotherapy

My 42yr old sister has a large tumor plus 2 smaller ones in one breast and she is leaning towards neoadjuvant chemotherapy.  One radiologist tod her it was attached to the cell wall and another radilogist said it was close but that if she did chemo first it might shrink it enough to do a lumpectomy rather than a mastectomy.  I'm not sure I understand why its good to put your body thru chemo before surgery.  Doesn't it deplete your red and white blood cells? One more question:  She had 2 small lesions on the other breast- 3mm- and the biopsy came back negative-  How can she be sure that they actually got a piece of it and not just the surrounding tissue?  The radiologist even left "tags/markers" there during the biopsy-Im assuming because she thought they were cancerous.  Thanks for any answers!

[PaulMD]

Hi there.

Neoadjuvant chemotherapy aims to shrink the tumor and any of the accompanying small nodules so that breast conservation surgery can be easily accomplished and also that safe margins around the tumor during the surgery can be met.  Our bone marrow recovers after 2-3 weeks of chemotherapy and this should not and would not affect the surgery.  Tags/markers are placed around the tumor area so that the surgeon would know where to resect the tumor in case the tumor completely disappears during chemotherapy (so called "complete response").  Neoadjuvant chemotherapy sounds like a good plan for your sister.  

Regards and God bless...