Breast cancer Chemotherapy can be given in following situations:

Chemotherapy for early Breast Cancer after surgery

After you have a breast Surgery to remove a tumour, your doctor can prescribe Chemotherapy to kill any undetected cancer cells and to reduce your recurrent cancer risk. This known as adjuvant Chemotherapy.

The doctor may prescribe adjuvant Chemotherapy if you have a high risk of recurring or spreading the cancer to other parts of your body (metastasizing), even though after Surgery there is no evidence of cancer. When cancer cells are present in lymph nodes near the breast with the tumour, you could be at greater risk of metastasis.

When considering adjuvant chemotherapy, ask your doctor how much the Chemotherapy will lower the risk of returning to cancer. Together you should balance this decreased risk against the Chemotherapy side effects. Also, discuss other alternatives with your doctor, such as hormone-blocking therapy, which might be effective in your situation.

Chemotherapy before Surgery for early breast cancer

Chemotherapy is often given to reduce larger tumours before Surgery (neoadjuvant therapy). This could:

Allow the surgeon the best chance to fully remove the tumour

Require the surgeon to remove only the tumour, not the whole breast.

Increasing the level of disease in lymph nodes, requiring less invasive treatment of the lymph nodes

Minimize risk of cancer returning

Allow assessment of the tumour response to therapy to help explain the prognosis and choose the best drug for chemotherapy

Neoadjuvant therapy is often used for:

• Inflammatory breast cancer
• HER2-positive breast cancer
• Triple-negative breast cancers
• High-grade tumours
• Cancers that spread to the lymph nodes
• Large tumours

Treatment to reduce Breast Cancer risk

Preventive drugs (called chemoprevention) minimize the risk of Breast Cancer in women with high disease risk. They typically include drugs that block estrogen, such as selective modulators of estrogen receptors and aromatase inhibitors. Such medications carry a risk of side effects, so doctors reserve such medicines for women who are at high risk for Breast Cancer. Talk with your doctor about the benefits and risks.

Chemotherapy as the primary treatment for advanced breast cancer:

If Breast Cancer has spread to other areas of the body, and Surgery is not an option, the primary treatment could be Chemotherapy. This should be used alongside guided counseling.

The primary goal of advanced Breast Cancer Chemotherapy is usually to enhance efficiency and survival, rather than cure the disease.

Chemotherapy medications used for early Breast Cancer diagnosis include:

Anthracyclines: This class of drugs includes doxorubicin and epirubicin

Taxanes: This class of drugs includes docetaxel and paclitaxel

These drugs are often used with others like carboplatin, cyclophosphamide, and fluorouracil.

Drugs used to treat advanced Breast Cancer include:

• Albumin-bound paclitaxel
• Capecitabine
• Eribulin
• Gemcitabine
• Ixabepilone
• Liposomal doxorubicin
• Mitoxantrone
• Vinorelbine

Side effects of Chemotherapy in breast cancer

Chemotherapy drugs travel all over the body. Side effects depend on the medications you are taking and the reaction to them. Within the course of treatment, side effects may get worse. Most side effects are transient and subside as soon as treatment is complete. Chemotherapy can have long-term, or lasting consequences in some situations.

Short Term Side Effects

Chemotherapy drugs can also damage other fast-growing healthy cells in the process of targeting rapidly growing cancer cells, such as those in the hair follicles, bone marrow, and digestive tract.

Several Chemotherapy drugs can affect nerve endings in your hands and feet, leading to numbness, pain, burning or tingling, cold or heat sensitivity, or weakness in your limbs. Such side effects often go away after treatment is done, or within one year after Chemotherapy is done. Those can be long-lasting in some situations.

“Chemo brain,” “chemo fog” and “chemo memory” are terms used to describe the controversial and incomprehensible short-term memory and concentration issues that may arise following Chemotherapy. In most cases, these issues go away within one year after the Chemotherapy is complete.

Common short-term side effects include:

• Hair loss
• Fatigue
• Loss of appetite
• Nausea and vomiting
• Constipation or diarrhoea
• Mouth sores
• Skin and nail changes
• Increased risk of developing infection (due to fewer white blood cells that help fight infection)
• Nerve damage (neuropathy)
• Problems with cognitive function that affect memory and concentration

Long-term side effects

Some Chemotherapy drugs for Breast Cancer can cause long-term side effects, including:

Infertility: Infertility is one possible side effect, which may not go away. Some anti-cancer drugs damage ovaries. This can cause symptoms of menopause, such as hot flashes and vaginal dryness. Menstrual cycles (amenorrhea) may become irregular or may cease. If ovulation stops, it becomes impossible to get pregnant.

Chemotherapy can induce a permanent premature menopause, depending on your age. Discuss your risk of enduring menopause and its consequences with your doctor.

When you keep on menstruating, you can still be able to become pregnant, even during care. However, because the results of Chemotherapy are risky for the foetus, consult with your doctor about options for birth control before beginning treatment.

Osteoporosis and Osteopenia: Women who undergo menopause early due to Chemotherapy may have a greater risk of osteopenia and osteoporosis in the bone-thinning conditions. These women are generally recommended to have periodic tests of bone density and, possibly, treatments to prevent further loss of bone.

Heart damage: Chemotherapy carries a slight risk of heart muscle weakening and causing other heart problems.

Breastfeeding: Breast Cancer Chemotherapy will rarely cause secondary cancer, such as blood cell cancer (leukaemia), several years after completion of the Chemotherapy.

Other side effects: Feelings of fear, sadness and isolation may compound the chemotherapy’s physical side effects, both during and after treatment. You constantly get in touch with and help from oncologists and nurses during Chemotherapy. All involved is working for the same target-completing treatment with the best result possible. Once it is over, you will feel as though you are on your own, with no one to help you back to regular life or cope with recurrence of Breast Cancer fears.

Consider talking to a mental health professional who works with cancer-stricken people. Talking to someone who has been in the same situation could also help. Connecting with others via a cancer survivor hotline, support group or online community.