The use of drugs to treat breast cancer is called chemotherapy or chemo for short. Chemotherapy medications attack cancer cells in the breast, combatting the destruction of healthy tissue and the disease’s expansion to other parts of the body. If the cancer has already metastasized, chemotherapy can be used to limit any further spread, reduce pain and other symptoms, and improve a patient’s quality of life. Physicians use chemotherapy in a variety of medical circumstances, often in combination with other forms of treatment, including surgery, radiation, and hormone therapies. 

Chemotherapy has proven to be an effective means of treating breast cancer. Though this type of therapy can have serious side effects, the health benefits outweigh the negatives in many cases.

Types of Breast Cancer Chemotherapy

There are three primary types of chemotherapy is utilized to treat breast cancer:

• Before surgery (neoadjuvant chemotherapy): Breast cancer chemotherapy before surgery is sometimes used to shrink tumors prior to their surgical removal. The medical term for this type of chemotherapy is neoadjuvant. Neoadjuvant chemotherapy has several advantages as a form of care. Most importantly, it increases the likelihood of eliminating the entire cancer from the body. It also generates valuable information for the medical team on how best to treat a specific instance of the disease. 
• After surgery (adjuvant chemotherapy): Chemotherapy is also deployed following surgery, as a means of killing any remaining cancer cells that may have been missed during the operation. This is known as adjuvant chemotherapy. 
• In advanced cases: A third application of chemotherapy is targeting the disease once it has spread from the breast to the lymph nodes and other parts of the body. Used in this manner, chemotherapy has proven successful in limiting symptoms and increasing rates of survival. 

How is Chemotherapy for Breast Cancer Given?

Chemotherapy medications are typically given intravenously, either by injection or infusion (that is, by drip method via specially designed IV devices). Some chemo drugs are available in pill form. Delivery can take place in a doctor’s office, hospital, outpatient facility, or cancer-treatment clinic. Most chemotherapy is provided in cycles, with periods of treatment followed by periods without. This allows healthy cells to recover that are sometimes affected by chemo medications. Depending on the nature and circumstances of the therapy, treatment periods can run from a couple of weeks to as many as six months in duration.

Side Effects of Chemotherapy for Breast Cancer

Chemotherapy is a systemic form of treatment, meaning that the drugs that attack cancer cells are also present in other parts of the body, and can damage healthy cells as well as diseased ones. This leads to side effects that can be categorized as short term and long term. Most side effects diminish over time once you’ve completed your treatments, though there are exceptions.

Short-term Side Effects of Breast Cancer Chemotherapy:

• Loss of hair
• Nausea, vomiting, and loss of appetite
• Constipation and diarrhea
• Fatigue and feelings of weakness
• Numbness and tingling or burning sensations in your arms and legs
• Modification of skin and nails
• Sores, especially in the mouth
• Short-term memory and concentration problems (“chemo fog”)
• Increased infection risk

Long-term Side Effects of Breast Cancer Chemotherapy

The long-term effects can be more serious. These include possible infertility, bone disease (osteoporosis), heart ailments, and leukemia.

• Infertility. Cancer treatment can sometimes trigger an early and permanent menopause. This reduces or eliminates the possibility of pregnancy.
• Heart trouble. Chemotherapy and chemotherapy medicine can damage the heart. This damage can lead to various heart complications.
• Bone density loss. Women undergoing chemotherapy are more at risk for osteoporosis and osteopenia. Both conditions involve a thinning of the bones.
• Leukemia. Although rare, chemotherapy might lead to cancer in the blood a few years after treatment.

There is also a psychological dimension to undergoing chemotherapy. Feelings of anxiety and despair during treatment can be replaced by a sense of loneliness and isolation afterwards, coupled with a fear of cancer returning. Be sure to rely on supportive family members and friends, or become involved in a cancer-survivors’ group following treatment.

How Does My Physician Determine My Chemotherapy Needs?

Like other cancer treatments, chemotherapy is more effective in some circumstances than in others. Your physician will determine the types, combinations, and duration of your chemotherapy treatment based on a number of variables. These include:

• Your tumor size and grade: Tumor size and grade are clues as to the cancer’s degree of development. The greater the likelihood that the cancer is growing rapidly and has spread, the more important chemotherapy becomes as a means of treatment.
• Your health status: An otherwise healthy individual with cancer can stand the rigors of chemotherapy better than someone who has health problems in addition to a malignancy. 
• Any previous treatments: Previous treatments for cancer, including earlier rounds of chemotherapy, can impact the nature of future care.
• Your age: Breast cancers in young women tend to be more aggressive than those occurring later in life. Chemotherapy is often used in these circumstances to reduce the possibility of the disease’s return.
• Your genetic profile and hormonal risk: Genetic profiles are done to determine whether breast cancer cells are hormone receptor positive – that is, their growth and spread is encouraged by the presence of female sexual hormones (estrogen and progesterone). If that is the case, your physician may choose to start treatment with hormone therapy rather than chemotherapy, as a more precisely targeted means of attacking the disease, with fewer potential side effects.
• HER2 levels: HER2 is a growth-encouraging protein produced by some types of breast cancer. Certain chemotherapy drugs are designed to attack and disable this protein. 
• Evidence of lymph-node infection: If cancer spreads from the breast, often the first place it appears is in the lymph nodes. If your physician finds evidence of this, he or she is more likely to recommend chemotherapy. 

Your physician will also consider the feasibility of combining chemotherapy with other cancer treatments.

How to Prepare for Chemotherapy

If your physician determines that chemotherapy is appropriate for you, there are several steps you can take to help prepare yourself for treatment:

• Maintain your health: Remain active, eat well, get rest, and limit stress. 
• Get ready for the side effects: Know what to expect and how you might respond if side effects occur.
• Arrange for help from family members, friends, and colleagues: There will be times when you’re unable to maintain a normal level of activity. Plan ahead by having loved ones and others cover for you. 
• Provide detailed information to your physician about current medications and other supplements: This is necessary to avoid potential interactions that might reduce the effectiveness of your breast-cancer drugs. 
• Develop a treatment routine: You may be limited in what you are allowed to eat and drink on the days you’re receiving chemo. You’ll want to have friends or family members at hand, to assist in practical matters like driving and to offer comfort and support. 

You’ll see your physician regularly after completing chemotherapy for breast cancer. He or she will evaluate the effectiveness of your treatment. This process will continue indefinitely, to ensure that you remain cancer-free. If the treatment is unsuccessful or your cancer returns, your physician will devise a new plan for addressing it.