Chemotherapy for breast cancer

Chemotherapy for breast cancer

Chemotherapy (chemo) is treatment with cancer-killing drugs that may be given
intravenously (injected into a vein) or by mouth. The drugs travel through the
bloodstream to reach cancer cells in most parts of the body. Chemo is given in cycles,
with each period of treatment followed by a recovery period. Treatment usually lasts for
several months.
When is chemotherapy used?
There are several situations in which chemo may be recommended.
After surgery (adjuvant chemotherapy): When therapy is given to patients with no
evidence of cancer after surgery, it is called adjuvant therapy. Surgery is used to remove
all of the cancer that can be seen, but adjuvant therapy is used to kill any cancer cells that
may have been left behind but can't be seen. Adjuvant therapy after breast-conserving
surgery or mastectomy reduces the risk of breast cancer coming back. Radiation, chemo,
and hormone therapy can all be used as adjuvant treatments.
Even in the early stages of the disease, cancer cells may break away from the primary
breast tumor and spread through the bloodstream. These cells don't cause symptoms, they
don't show up on imaging tests, and they can't be felt during a physical exam. But if they
are allowed to grow, they can establish new tumors in other places in the body. The goal
of adjuvant chemo is to kill undetected cells that have traveled from the breast.
Before surgery (neoadjuvant chemotherapy): Chemo given before surgery is called
neoadjuvant therapy. Often, neoadjuvant therapy uses the same chemo that is used as
adjuvant therapy (only it is given before surgery instead of after). In terms of survival,
there is no difference between giving chemo before or after surgery. The major benefit of
neoadjuvant chemo is that it can shrink large cancers so that they are small enough to be
removed with less extensive surgery. The other advantage of neoadjuvant chemo is that
doctors can see how the cancer responds to the chemo drugs. If the tumor does not shrink
with the first set of drugs, your doctor will know that other chemo drugs are needed.
Some breast cancers are too big to be surgically removed at the time of diagnosis. These
cancers are referred to as locally advanced and have to be treated with chemo to shrink
them so they can be removed with surgery.
For advanced breast cancer: Chemo can also be used as the main treatment for women
whose cancer has spread outside the breast and underarm area, either when it is
diagnosed or after initial treatments. The length of treatment depends on whether the
cancer shrinks, how much it shrinks, and how a woman tolerates treatment.