Chemotherapy for breast cancer

You usually have chemotherapy in a chemotherapy day unit. You usually have it into a vein (intravenously). But some people are given chemotherapy tablets.

If you have chemotherapy intravenously, you have it by injection or as a drip (infusion). You may have:

• a cannula – a short, thin tube the nurse puts into a vein in your arm or hand
• a PICC line – a fine tube that is put into a vein in your arm and goes up into a vein in your chest
• an implantable port (portacath) – a disc that is put under the skin on your chest or arm and goes into a vein in your chest.

You usually have chemotherapy as a few sessions of treatment. Each session takes a few hours. After the session, you have a rest period. The session and rest period together are called a cycle.

The length of a cycle depends on the chemotherapy drugs you are having. Most cycles are 1 to 3 weeks. Your cancer doctor or nurse will tell you how many cycles you need.

Different chemotherapy drugs affect cancer cells in different ways. This is why a combination of drugs is often used. For early breast cancer, the combination usually includes drugs called:

• anthracyclines – such as epirubicin and doxorubicin
• taxanes – such as docetaxel, paclitaxel, and nab-paclitaxel.

These drugs are commonly used in combination with other chemotherapy drugs, including cyclophosphamide and carboplatin.

If you are having both an anthracycline and a taxane, they will usually be given one after another. Your cancer doctor or nurse will explain the order you have them.

Some commonly used combinations are:

• AC – doxorubicin (Adriamycin®) and cyclophosphamide
• EC – epirubicin and cyclophosphamide
• TC – docetaxel (Taxotere®) and cyclophosphamide
• carboplatin with paclitaxel or docetaxel
• EC-T – epirubicin and cyclophosphamide, followed by docetaxel
• EC-P – epirubicin and cyclophosphamide, followed by paclitaxel.

Your cancer doctor may offer you a choice of chemotherapy drugs. They will give you information to help you decide.

If you have HER2 positive breast cancer, you will have targeted therapy drugs called trastuzumab or pertuzumab. Or you may have both.

After surgery, you may continue having the drugs you had before surgery. Or you may change to trastuzumab emtansine.

These may be given if there is a higher risk of the cancer coming back, to reduce the risk. We have more information about targeted therapy for breast cancer.

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