A high percentage of breast cancer do not require chemotherapy. This mainly includes early stages of breast cancers that are sensitive to hormones. We usually treat Hormone-sensitive early breast cancers with surgery first and then give patients breast radiotherapy (unless they have had a mastectomy) and oral endocrine treatment for 5 to 10 years. Chemotherapy for breast cancer is used in two major settings:
- High-risk breast cancer that has been (or will be) removed completely by surgery.
- Stage 4 Breast cancer
High-risk breast cancer:
This includes all breast cancers that have not spread outside the breast and surrounding lymph nodes, but the risk of them coming back after surgery is high. In this case, we use chemotherapy soon after surgery to destroy any cancer cells that may have spread to other organs (before surgery) and have the ability to start cancer again anytime in the future. Sometimes, we use chemotherapy before surgery to reduce the size of breast cancer and make surgery more successful. This may enable surgeons to avoid doing a mastectomy by reducing the size of the area they are going to remove. Chemotherapy before surgery will also destroy cancer cells that may have spread to other parts of the body before surgery. This should reduce the risk of cancer recurrence in the future.
Stage-4 breast cancer:
Although stage-4 breast cancer cannot be cured, treatment may keep it in remission (dormant) for a number of years. We may use chemotherapy, but we may also use endocrine treatment, targeted therapy and sometimes radiotherapy to slow the progression of the disease and improve patients’ quality of life. Chemotherapy can achieve rapid response but is toxic and may sometime worsen patients’ quality of life. Therefore, we use it for cancers that are growing fast and we want to achieve a quick and effective response. We are also likely to use it when breast cancer is not sensitive to endocrine therapy.
Facts about chemotherapy:
- There are many types of chemotherapy drugs, some based on natural plant compounds and others using man-made chemicals.
- Chemotherapy drugs can be given on its own or in combination with other chemotherapy drugs.
- Chemotherapy is given in three-weekly (once every three weeks) cycles.
- A cycle is the day of chemo administration and the following three weeks which are usually given to allow recovery from chemotherapy side effects.
- The majority of chemotherapy drugs are given intravenously but some of them are given orally as tablets.
- Chemotherapy can be combined with targeted therapy but is not usually given together with endocrine treatment
Here you will find a list of the most common chemotherapy drugs used for treating Breast cancer. Please click on the link to read more about each drug.
Pertuzumab, trastuzumab and docetaxel