Chemotherapy for breast cancer

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, you may only need part of the breast removed instead of a mastectomy.

Women with inflammatory breast cancer usually have chemotherapy before surgery.

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

How chemotherapy is given

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

When you have intravenous chemotherapy, the nurse will give you the drugs as an injection into a vein 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.

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 are taking, but most cycles are between one and three weeks long. Your doctor or nurse will explain more about this. Most courses of chemotherapy are made up of six cycles.

The drugs used

You have a combination of different chemotherapy drugs. Some commonly used combinations include:

  • FEC – fluorouracil (5FU), epirubicin and cyclophosphamide
  • FEC-T – FEC followed by docetaxel (Taxotere®)
  • AC or EC – doxorubicin (Adriamycin®) and cyclophosphamide or epirubicin and cyclophosphamide
  • TC – docetaxel and cyclophosphamide
  • EC-T – epirubicin and cyclophosphamide followed by docetaxel (Taxotere®)
  • EC-P – epirubicin and cyclophosphamide followed by paclitaxol (Taxol®)
  • FEC-P – fluorouracil (5FU), epirubicin and cyclophosphamide followed by paclitaxol (Taxol®).

Your doctor may offer you a choice of chemotherapy treatments. If so, you will be given more information to help you make a decision.

If you have HER2 breast cancer, you may have a targeted therapy called trastuzumab (Herceptin®) along with your chemotherapy.

We have more information about individual chemotherapy drugs and combinations.

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