I am now facing the dilemma of the Optima trial. I am 54 with a 4.7mm Grade 3 tumour HER Negative ER weakly positive. 3 lymph nodes are involved.My treatment plan was originally chemotherapy first, on the trial it's a simple mastectomy first. I am wondering if there is a disadvantage having surgery first and then potentially chemotherapy. How have others got on with the trial?