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Chemotherapy for Breast Cancer
Chemotherapy uses drugs to destroy breast cancer cells. The drugs enter the bloodstream and travel through the body to the cancer cells. Chemotherapy may be used:
- Before surgery—to shrink the tumor and decrease the amount of tissue that needs to be removed
- After surgery—to kill any remaining cancer cells and decrease risk of return
- To help relieve symptoms of metastatic cancer and extend survival time
Chemotherapy may also be used in conjunction with other therapies like radiation treatment, biologic therapy, or hormone blocking therapy.
Chemotherapy Drugs and Delivery
There are a variety of chemotherapy drugs. The choice and combination of drugs will be based on your particular cancer and reaction to drugs. Chemotherapy drugs for breast cancer may include:
- Cyclophosphamide, methotrexate, and 5-fluorouracil (CFM)
- Cyclophosphamide, doxorubicin, and fluorouracil (CAF)
- Doxorubicin and cyclophosphamide (AC)
- Doxorubicin and cyclophosphamide followed by paclitaxel, docetaxel concurrent with AC, or docetaxel (TAC)
- Doxorubicin, followed by CMF
- Docetaxel and cyclophosphamide (TC)
- Cyclophosphamide, epirubicin, and fluorouracil with or without docetaxel
Chemotherapy is usually given by IV, but some forms can be given by mouth as well. IV chemotherapy is delivered in cycles over a set period of time. A medical oncologist will determine how many cycles of chemotherapy are needed and what combination of drugs will work best.
Side Effects and Management
Though the drugs are targeted to cancer cells, they can affect healthy cells as well. The death of cancer cells and impact on healthy cells can cause a range of side effects. A medical oncologist will work to find the best drug combination and dosage to have the most impact on the cancer cells and minimal side effects on healthy tissue. Side effects or complications from chemotherapy may include:
- Nausea and vomiting
- Hair loss
- Memory and/or cognitive problems
- Low blood cell counts (red cells, white cells, or platelets) that can lead to infection or bleeding
- Premature menopause—including symptoms and loss of fertility
Long term effects may include heart muscle damage (with doxorubincin) and rarely, leukemia.
A variety of treatments are available to help manage side effects including medication, lifestyle changes, and alternative treatments. In some cases, the chemotherapy regimen may be adjusted to reduce severe side effects. The earlier the side effects are addressed, the more likely they will be controlled with a minimum of discomfort.
Breast cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003090-pdf.pdf. Accessed October 30, 2015.
Breast cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/breast-disorders/breast-cancer. Updated September 2013. Accessed October 30, 2015.
Breast cancer in women. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113654/Breast-cancer-in-women. Updated September 14, 2016. Accessed October 3, 2016.
Chemotherapy for early and locally advanced breast cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114271/Chemotherapy-for-early-and-locally-advanced-breast-cancer. Updated September 19, 2016. Accessed October 3, 2016.
Chemotherapy for metastatic breast cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T900469/Chemotherapy-for-metastatic-breast-cancer. Updated February 6, 2015. Accessed October 3, 2016.
Treatment option overview. National Cancer Institute website. Available at: http://www.cancer.gov/types/breast/patient/breast-treatment-pdq#section/%5F185. Updated October 22, 2015. Accessed October 30, 2015.
- Reviewer: Mohei Abouzied, MD
- Review Date: 12/2014
- Update Date: 10/30/2015