Chemotherapy for Breast Cancer

Chemotherapy is a cytotoxic drug that is used to destroy breast cancer cells. It is known as a systemic treatment because the whole body is exposed to the drugs.

How chemotherapy works

Cancer cells grow by dividing in an uncontrolled way. Chemotherapy aims to interfere with their ability to divide and grow.

Different chemotherapy drugs work in different ways and attack the cancer cells at different phases of their growth. This is why a combination of drugs is often used.

How chemotherapy is used

You’ll usually be offered chemotherapy if cancer cells have been found in the lymph nodes under the arm. Even if there is no spread to the nodes, chemotherapy may be offered based on other factors, including the size and grade of your breast cancer.

Chemotherapy is commonly given in addition to surgery and/or radiotherapy for primary breast cancer, and it is usually given after surgery and before radiotherapy. This is known as adjuvant chemotherapy and it starts between three and four weeks after surgery, giving your body some time to recover from the effects of the operation.

Some people may be offered chemotherapy treatment before surgery has taken place. This is called neo-adjuvant chemotherapy or primary chemotherapy. It may be used in this way to slow the growth of tumors that are growing rapidly or to shrink larger tumors.

Secondary, or metastatic, breast cancer is when breast cancer cells have spread from the breast to other parts of the body, such as the bones or lungs. Chemotherapy can be given to shrink or control the growth of secondary breast cancer. It can also be given to reduce some symptoms.

Benefits of chemotherapy

Research shows that people of all ages may benefit from chemotherapy. How effective it is depends on:

  • what type of breast cancer you have
  • the size of the tumor
  • the stage of the cancer
  • the grade of the cancer

The benefits of chemotherapy are often clear, but if they are less obvious it can be difficult to decide whether or not to have the treatment. You’ll need to weigh up the likely benefits against the potential side effects.

Your decision may be influenced by personal priorities, your family, and your work commitments. It’s important for you to discuss these issues openly with your cancer specialist or breast care nurse, who will help and support you with your decision.

Duration of chemotherapy

Chemotherapy for breast cancer is usually given as a series of treatments every two to four weeks over a period of four to six months. This can vary, depending on the type and stage of your cancer, your general health and the combination of drugs used.

The gap between courses of treatment gives your body time to recover from any short-term side effects that might occur.

You’ll normally be given your treatment as an outpatient so you’ll be able to go home the same day. On each treatment day, you should expect to be at the hospital for most of the day to allow for waiting time and for treatment.

With some types of chemotherapy you may be given your first treatment as an inpatient and stay in hospital overnight.