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Chemotherapy for Breast Cancer

Chemotherapy uses drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body. It may be used:

  • Before surgery—to shrink the tumor
  • After surgery—to kill cells that are left behind
  • To help ease symptoms caused by the tumor

Chemotherapy may also be used with other therapies like radiation treatment, biologic therapy, targeted therapy, or hormone blocking therapy.

Chemotherapy Drugs and Delivery

There are many kinds of chemotherapy drugs. The drugs and how they are used will depend on the type of cancer. Breast cancer may be treated with:

  • 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 most often given through an IV. It's done in cycles over a set time.

Side Effects and Management

Chemotherapy can cause a range of health problems. The most common are:

  • Nausea or vomiting
  • Feeling very tired
  • Hair loss
  • Problems with memory or thinking clearly
  • 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 (doxorubincin) and rarely, leukemia.

There are many ways to manage these problems. Medicines and lifestyle changes are the most common. In some cases, the cycles may be changed to lower the chances of serious problems. Talk to your care team as soon as these appear so they can be better controlled.

REFERENCES:

Breast cancer. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gynecology-and-obstetrics/breast-disorders/breast-cancer. Updated January 2018. Accessed March 12, 2019.

Breast cancer in women. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113654/Breast-cancer-in-women. Updated November 26, 2018. Accessed March 12, 2019.

Chemotherapy for breast cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/breast-cancer/treatment/chemotherapy-for-breast-cancer.html. Updated October 3, 2017. Accessed March 12, 2019.

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 June 14, 2018. Accessed March 12, 2019.

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 November 12, 2018. Accessed March 12, 2019.

Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/breast/patient/breast-treatment-pdq#section/_185. Updated February 6, 2019. Accessed March 12, 2019.

Last reviewed December 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP