When is chemotherapy needed for breast cancer

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

This information is for those who are deciding about chemotherapy for early-stage breast cancer. It is not about surgery or hormone therapy. Breast cancer occurs when abnormal cells grow out of control in one or both breasts.

These cells can invade nearby tissues and form a mass, called a malignant tumour. The cancer cells can spread metastasize to the lymph nodes and other parts of the body. The first treatment for early-stage breast cancer usually includes surgery and sometimes radiation.

Your doctor may also talk to you about added treatment, such as chemotherapy "chemo" and hormone therapy , that may help keep cancer from coming back. Some people think of added treatment as an insurance policy designed to destroy any cancer cells that may still be in the body. It isn't possible for all women to know for sure who will benefit from added treatment. Gene tests, such as the Oncotype DX, may be done on the cancerous tissue that was removed to look for tumour markers.

These tests can give your doctor important information about whether chemotherapy will help you. The type of added treatment you have depends on the stage and classification of your breast cancer:. Different chemotherapy medicines tend to cause different side effects. Many women do not have problems with these side effects, while other women are bothered a lot. There are other medicines you can take to treat the side effects of chemo. Talk to your doctor about the type of chemotherapy medicine that he or she is planning to give you.

Ask about any side effects that the chemo may cause. Your doctor may use a genetic test to find your risk for having your cancer come back. Or your doctor may use a computer program, such as Adjuvant! This information can help you and your doctor decide about chemotherapy. These stories are based on information gathered from health professionals and consumers.

They may be helpful as you make important health decisions. I was diagnosed with breast cancer 3 years ago. It was quite a shock. Even though my breast cancer was small and I did not have any cancer cells in my lymph nodes, I decided to take chemotherapy. My doctor said that even though it would not guarantee that the cancer would not come back, it would improve my chances for a cure. I was really worried about the side effects, but they were not that bad.

I just wanted to do everything in my power to beat this breast cancer. My checkups have been fine so far, so I think I made the right choice. I was diagnosed with breast cancer about 3 years after I went through menopause. My breast cancer was small, and I did not have any cancer in my lymph nodes. I stopped taking my menopause hormones, had surgery and radiation, and have been taking tamoxifen ever since.

I see my doctor a couple of times a year and so far have been okay. I'm going to ask my doctor if I'm a good candidate for switching to something like Arimidex. I hear that it's a smart choice for some women. I found out about my breast cancer earlier this year. I don't have a family history of it or any of the risk factors that you read about. I chose to have a lumpectomy. My doctor had some gene tests done on the tissue that was removed during my surgery. The tests showed that my cancer was not very aggressive and that chemotherapy would not be helpful for me.

So instead I'm taking letrozole every day. I got breast cancer 2 years ago. What a surprise! I don't have any family history that I know of , and I don't have the other risk factors that my doctor talked to me about. Fortunately, my breast cancer was really small, and it hadn't travelled to the lymph nodes under my arm. My doctor used the Adjuvant!

I keep in close contact with my doctor and really feel great. I think that passing on the chemo was the right decision for me. It may also help to talk with someone who has been in the same situation. Connect with others through a hotline, support group or online community for people who have been treated for cancer. Genetic profile. For certain types of breast cancer such as hormone receptor positive breast cancer, your doctor may have your cancer cells tested to learn more about their genetic makeup.

Gene expression profiling tests, such as Oncotype DX, EndoPredict and MammaPrint, may help predict the risk of recurrence and give your doctor an idea of how your cancer cells might respond to chemotherapy.

If it's not clear whether you'd benefit from chemotherapy, these tests can be helpful. But they're not useful for everyone and are only used in certain situations.

Make healthy choices before cancer treatment so you'll feel strong as your treatment begins. Continuing healthy choices during treatment may help minimize side effects. Ask your doctor what side effects you can expect during and after chemotherapy. If you know what to expect, you can prepare. For example, if your chemotherapy treatment will cause infertility, you may wish to store sperm, fertilized eggs embryos or eggs for future use. If your chemotherapy will cause hair loss, consider a wig or a head covering, or talk to your doctor about measures that may prevent hair loss.

Most people are able to continue working and doing their usual activities during chemotherapy. Your doctor can give you an idea of how much the chemotherapy will affect your usual activities, but it's difficult to predict just how you'll feel. Prepare by asking for time off work or help at home for the first few days after treatment. If you'll be in the hospital during chemotherapy treatment, arrange to take time off work and find someone to take care of your usual responsibilities at home.

Medications or supplements you're taking, including any herbal supplements, vitamins or over-the-counter drugs, may affect the way the chemotherapy drugs work. Your doctor may suggest alternative medications or that you not take the medications or supplements for a period before or after a chemotherapy session.

Your doctor or nurse will let you know what you can and can't eat or drink on the day of your chemotherapy session. It may help to take a family member or friend with you to the treatment session for support and companionship.

Chemotherapy for breast cancer is given in cycles. The cycle for chemotherapy can vary from once a week to once every three weeks. Each treatment session is followed by a period of recovery. Typically, if you have early-stage breast cancer, you'll undergo chemotherapy treatments for three to six months, but your doctor will adjust the timing to your circumstances.

If you have advanced breast cancer, treatment may continue beyond six months. If you have early-stage breast cancer and you are also scheduled to receive radiation therapy, it usually happens after chemotherapy.

There are many chemotherapy drugs available. Because each person is different, your doctor will tailor the type and dose of medications regimen — often a combination of two or three chemotherapy drugs — to your type of breast cancer and medical history. Breast cancer chemotherapy sessions can take place at your doctor's office, at an outpatient unit in a hospital or clinic, or at home. Chemotherapy drugs can be given in a variety of ways, including as pills you take at home. Most often they're injected into a vein IV.

This can be done through:. Some people feel fine after a chemotherapy session and can return to their schedules and activities. Others may feel side effects more quickly. You may want to arrange for someone to drive you home afterward, at least for the first few sessions, until you see how you feel.

However, because of tests, waiting times and how long it takes to prepare and give the chemotherapy drugs, some people are there for most of the day. You may be asked to have blood tests a few days before you have your chemotherapy. You might find it helpful to take things to help pass the time as well as snacks and drinks. You may be able to take someone to go with you to keep you company. Talk to your chemotherapy nurse to find out if this is possible. With some types of chemotherapy you may be given your first treatment as an inpatient and may need to stay in hospital overnight.

Chemotherapy is commonly given as a series of treatments with a break between each treatment to give your body time to recover from any short-term side effects. The treatment and period of time before the next one starts is called a cycle. You may have one drug or a combination of two or three drugs. The exact type and dose of chemotherapy will be tailored to your individual situation.

The length of time that you have chemotherapy will depend on your individual situation. Your treatment team will discuss this with you. Like any treatment, chemotherapy can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others. Find out about the side effects of chemotherapy. Many people find that complementary therapies help them cope with the side effects of chemotherapy, even though there may not be the evidence to support this.

Check with your treatment team or GP before having any complementary therapies, and mention your breast cancer and treatment to any therapist you see. You may be able to eat normally throughout chemotherapy or your eating habits may change because of side effects. Find out more about diet during treatment. The evidence is not clear whether supplements such as vitamins, particularly high-dose antioxidants including vitamins A, C and E, co-enzyme Q10 and selenium , are harmful or helpful during chemotherapy.

You can still have sex during treatment. Most treatment teams will advise using barrier methods of contraception, such as condoms during treatment, and for a few days after chemotherapy is given. Your specialist will usually recommend barrier methods of contraception, such as condoms.

The contraceptive pill is not usually recommended because it contains hormones. Emergency contraception such as the morning after pill can still be used. Find out more about how breast cancer and its treatment can affect sex and intimacy and read our tips on how to manage these changes. Live vaccines include mumps, measles, rubella German measles , polio, BCG tuberculosis , shingles and yellow fever. Live vaccines contain a small amount of live virus or bacteria.

There are tests available, such as Oncotype DX, that can help determine which women will most likely benefit from chemo after breast surgery. Chemotherapy can be given before surgery neoadjuvant or after surgery adjuvant. In most cases, chemo is most effective when combinations of drugs are used. Today, doctors use many different combinations, and it's not clear that any single combination is clearly the best. Although drug combinations are often used to treat early breast cancer, advanced breast cancer more often is treated with single chemo drugs.

Still, some combinations, such as paclitaxel plus gemcitabine, are commonly used to treat advanced breast cancer. See Targeted Therapy for Breast Cancer for more information about these drugs. Chemo drugs for breast cancer are typically given into a vein IV , either as an injection over a few minutes or as an infusion over a longer period of time. Often, a slightly larger and sturdier IV is required in the vein system to administer chemo. They are used to put medicines, blood products, nutrients, or fluids right into your blood.

They can also be used to take out blood for testing. There are many different kinds of CVCs. The most common types are the port and the PICC line. For breast cancer patients, the central line is typically placed on the side opposite of the underarm that had lymph nodes removed for the breast cancer surgery. Chemo is given in cycles, followed by a rest period to give you time to recover from the effects of the drugs.

Cycles are most often 2 or 3 weeks long. The schedule varies depending on the drugs used. For example, with some drugs, the chemo is given only on the first day of the cycle. With others, it is given for a few days in a row, or once a week. Then, at the end of the cycle, the chemo schedule repeats to start the next cycle. Adjuvant and neoadjuvant chemo is often given for a total of 3 to 6 months, depending on the drugs used. The length of treatment for advanced breast cancer depends on how well it is working and what side effects you have.