Chemotherapy for breast cancer
Chemotherapy uses drugs to kill cancer cells or slow their growth. It is usually given before radiation therapy and may be used if:
- the cancer needs to be shrunk or controlled before surgery (neoadjuvant chemotherapy)
- the cancer is not sensitive to hormone therapy and/or is HER2 positive
- the risk of the cancer returning is high
- the cancer returns after surgery or radiation therapy (to gain control of the cancer and relieve symptoms).
Many different types of chemotherapy drugs are used to treat early and locally advanced breast cancer. The drug combination you are given will depend on the type of cancer, how far it has spread and what other treatments you are having. Common drugs include doxorubicin, cyclophosphamide, fluorouracil, docetaxel and paclitaxel. Your health professionals may also refer to the drugs by their brand names.
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Chemotherapy is given through a vein (intravenously). You will usually be treated as an outpatient, but occasionally you may have to stay in hospital overnight.
Most people will have chemotherapy for 3–6 months. Some drugs are given once every three weeks, others are given on a faster schedule (e.g. once every two weeks or once a week). Not every person with breast cancer will have the same chemotherapy treatment on the same schedule.
Chemotherapy damages cells as they divide. This makes the drugs effective against cancer cells, which divide rapidly. However, some normal cells – such as hair follicles, blood cells and cells inside the mouth or bowel – also divide rapidly. Side effects happen when chemotherapy damages these normal cells. Unlike cancer cells, normal cells can recover, so most side effects are temporary. Side effects can often be prevented or managed by your treatment team.
Hair loss − Most people who have chemotherapy for breast cancer lose their head and facial hair. Some treatment centres provide cold caps, which may prevent total head hair loss, but this depends on the drugs used. For information about cold caps, speak to your treatment team. Learn more about wigs.
Infertility − Some women find that their periods become irregular or stop during chemotherapy. Periods may return to normal after treatment, or they may stop permanently (menopause), causing infertility. For men, chemotherapy can lower the number of sperm produced, which can cause temporary or permanent infertility. If you may want to consider having children in the future, talk to your cancer specialists about the options and ask for a referral to a fertility specialist before your treatment starts.
Other side effects – Common side effects include tiredness, mouth ulcers, nausea and vomiting, and constipation. Chemotherapy can also lower your immune system, increasing the risk of infection. Some people experience pins and needles (peripheral neuropathy).
For more on this, see Chemotherapy.
Video: What is chemotherapy?
Prof Christobel Saunders, Professor of Surgical Oncology and Head, Division of Surgery, The University of Western Australia, and Consultant Surgeon, Royal Perth, Fiona Stanley and St John of God Subiaco Hospitals, WA; Dr Marie-Frances Burke, Radiation Oncologist, Medical Director, Genesis CancerCare Queensland, QLD; Kylie Campbell, Breast Care Nurse and Clinical Lead, Murraylands, McGrath Foundation, SA; Carmen Heathcote, 13 11 20 Consultant, Cancer Council Queensland, QLD; Annmaree Mitchell, Consumer; Sarah Pratt, Nurse Coordinator, Breast Service, Peter MacCallum Cancer Centre, VIC; Dr Wendy Vincent, Breast Physician, Chris O’Brien Lifehouse and Royal Hospital for Women, Randwick, NSW, and Clinical Director BreastScreen NSW, Royal Prince Alfred Hospital, NSW; A/Prof Nicholas Wilcken, Director of Medical Oncology, Westmead Hospital, and Co-ordinating Editor, Cochrane Breast Cancer Group, NSW. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title. This booklet is funded through the generosity of the people of Australia.
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