Chemotherapy for breast cancer

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. You may have it after surgery to reduce the chances of breast cancer coming back. This is called adjuvant chemotherapy. Some women have chemotherapy before surgery to reduce the size of the cancer. This is called neo-adjuvant chemotherapy.

There are different ways of giving chemotherapy drugs. You will usually be given the drugs into a vein as an injection or as a drip. This is called intravenous chemotherapy. Some drugs are also given as tablets.

You will usually have chemotherapy as a day patient and go home after your treatment. You’ll then have a rest period for a few weeks before coming back for your next session. Most people have about six sessions of chemotherapy.

You will have a combination of chemotherapy drugs. Your doctor or nurse will explain which one would work best for you. They will also explain the possible side effects of the drugs.

What is chemotherapy?

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Cytotoxic means toxic to cells. These drugs disrupt the way cancer cells grow and divide but they also affect normal cells.


When you have chemotherapy

Your cancer specialist may recommend you have chemotherapy after surgery to reduce the risk of breast cancer coming back. This is called adjuvant chemotherapy. Your doctor or nurse will explain the benefits of this to you and the likely side effects.

You are usually offered chemotherapy if the cancer is:

Some women have chemotherapy before surgery to shrink a large cancer (neo-adjuvant treatment). If it works well, it you may only need part of the breast removed instead of a mastectomy. Women with inflammatory breast cancer usually have chemotherapy before their surgery.

Your cancer specialist may ask you to take part in a research trial that compares different types of chemotherapy.


How you have chemotherapy

You usually have chemotherapy in the chemotherapy day unit and go home after it. The drugs are usually given into a vein (intravenously) and some are taken as tablets.

When you have intravenous chemotherapy, the nurse will give you the drugs into a vein by injection or as a drip (infusion). You usually have them through a small tube (cannula) in your hand or arm. Sometimes they are given through a soft plastic tube called a central line or PICC line. These lines go into a large vein in your chest. Chemotherapy can also be given into a thin, soft plastic tube with a rubber disc (port), under the skin on your upper chest.

We have more information about lines and ports.

Chemotherapy is given into the vein as one or more sessions of treatment. Each session takes a few hours. After the session, you will have a rest period of a few weeks. The chemotherapy session and the rest period is called a cycle of treatment.

The length of a cycle depends on the chemotherapy drugs you’re taking, but most cycles are 1–3 weeks long. Your doctor or nurse will explain more about this. Most, but not all, courses of chemotherapy consist of six cycles.


The drugs used

You will have a combination of chemotherapy drugs. Some commonly used combinations are:

Adjuvant chemotherapy for breast cancer usually includes an anthracycline drug, such as epirubicin or doxorubicin. If there is a higher risk of the cancer coming back, docetaxel is also usually included. Your doctor may offer you a choice of chemotherapy treatments.

If you have HER2 breast cancer, you may have trastuzumab along with your chemotherapy.

Back to Chemotherapy explained

Your feelings

You may experience difficult feelings while having chemotherapy treatment. Talking these over can be helpful.

Where can you have chemotherapy?

You usually have chemotherapy in a chemotherapy day unit or clinic. If your treatment is more complex, you may need to stay in hospital.