What is Breast Cancer Chemotherapy?

Chemotherapy (chemo) employs anti-cancer medications that are administered either intravenously (into a vein) or orally. Most cancer cells in the body are reached by the medications as they travel through the bloodstream. If cancer spreads to the spinal fluid, which surrounds and cushions the brain and spinal cord, chemotherapy may be administered directly into this area (called intrathecal chemotherapy).

When is chemotherapy used for breast cancer?

Not all women with breast cancer will need chemo, but there are several situations in which chemo may be recommended.

After surgery (adjuvant chemotherapy):

Adjuvant chemo might be given to try to kill any cancer cells that might have been left behind or have spread but can't be seen, even on imaging tests. These cells are considered microscopic because they can’t be seen by the naked eye. If these cells were allowed to grow, they could form new tumors in other places in the body. Adjuvant chemo can lower the risk of breast cancer coming back. Sometimes it is not clear if chemotherapy will be helpful. There are tests available, such as Oncotype DX, that can help determine which women will most likely benefit from chemo after breast surgery. See Breast Cancer Gene Expression Tests for more information.

Before surgery (neoadjuvant chemotherapy):

Neoadjuvant chemo might be given to try to shrink the tumor so it can be removed with less extensive surgery. Because of this, neoadjuvant chemo is often used to treat cancers that are too big to be removed by surgery when first diagnosed, have many lymph nodes involved with cancer, or are inflammatory breast cancers.

If after neoadjuvant chemo, cancer cells are still found when surgery is done (also Called. residual disease), you might be offered more chemotherapy (adjuvant chemotherapy) to reduce the chances of cancer coming back (recurrence).

Other reasons you might receive neoadjuvant chemotherapy include:

Doctors can observe how cancer responds to therapy before removing the tumor. If the initial round of chemo medicines fails to shrink the tumor, your doctor will know that additional drugs are required. It should also eliminate any cancer cells that have spread but are not visible to the naked eye or on imaging tests. Neoadjuvant chemo, like adjuvant chemo, can reduce the risk of breast cancer recurring.

Some persons with early-stage cancer who receive neoadjuvant chemo may survive longer if the cancer is totally eradicated by the treatment. This is more common in women with triple-negative breast cancer or HER2-positive breast cancer.

Getting chemo before surgery can also give some people extra time to get genetic testing or plan reconstructive surgery.

Keep in mind that not all women with breast cancer are good candidates for neoadjuvant chemo.

advanced breast cancer:

Chemotherapy can be used as the primary treatment for women whose breast cancer has progressed to distant organs such as the liver or lungs. Chemotherapy can be administered either at the time of diagnosis or after initial treatments. The length of treatment is determined by how well the chemotherapy works and how well you tolerate it.

Breast cancer chemotherapy medications include:

Chemo has the greatest effect when more than one medicine is used at the same time. Combinations of two or three medications are frequently utilized. Doctors utilize a variety of pharmacological combinations, and it is unclear which combination is the best.

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