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. Doctors have found that giving the cycles of certain chemo drugs closer together can lower the chance that the cancer will come back and improve survival for some women.
For example, a drug that would normally be given every 3 weeks might be given every 2 weeks. This can be done for both neoadjuvant and adjuvant treatment. A chemo combination sometimes given this way is doxorub i cin Adriamycin and cyclophosphamide Cytoxan , followed by weekly paclitaxel Taxol. Chemo drugs can cause side effects. These depend on the type and dose of drugs given, and the length of treatment.
Some of the most common possible side effects include:. These side effects usually go away after treatment is finished. There are often ways to lessen these side effects.
For example, drugs can be given to help prevent or reduce nausea and vomiting. Other side effects are also possible. In some cases your doctor may recommend a "dose-dense" chemotherapy schedule.
Dose-dense chemotherapy usually means that the chemotherapy medicines are given about every 2 weeks, instead of a more routine schedule of every 3 weeks. Research has shown that dose-dense chemotherapy can improve survival and lower the risk of the breast cancer coming back compared to a traditional chemotherapy schedule.
Dose-dense chemotherapy doesn't allow as much time for the immune system and red blood cells to recover between chemotherapy cycles. Doctors sometimes use the medicines Neupogen chemical name: filgrastim or Neulasta chemical name: pegfilgrastim to strengthen the immune system, and Procrit chemical name: epoetin alfa , Epogen chemical name: epoetin alfa , or Aranesp chemical name: darbepoetin alfa to strengthen the red blood-cell system during dose-dense chemotherapy.
The decision to have a dose-dense or traditional chemotherapy schedule will be based on the chemotherapy being considered and your specific situation. Create a profile for better recommendations.
Breast implant illness BII is a term that some women and doctors use to refer to a wide range Sign up for emails about breast cancer news, virtual events, and more. Subscribe to our podcast for conversations on the issues that matter most. Join our online community to connect, share, and find peer support. They may send you to a doctor who specializes in radiation a radiation oncologist for evaluation.
For women who have a hormone receptor-positive ER-positive or PR-positive breast cancer, most doctors will recommend hormone therapy tamoxifen or an aromatase inhibitor, or one followed by the other as an adjuvant additional treatment, no matter how small the tumor is. Women with tumors larger than 0. Hormone therapy is typically given for at least 5 years.
A woman's age when she is diagnosed may help in deciding if chemo should be offered or not. Some doctors may suggest chemo for smaller tumors as well, especially if they have any unfavorable features a cancer that is growing fast; hormone receptor-negative, HER2-positive; or having a high score on a gene panel such as Oncotype DX. After surgery, some women with HER2-positive cancers will be treated with trastuzumab with or without pertuzumab for up to 1 year.
Many women with HER2-positive cancers will be treated with trastuzumab with or without pertuzumab followed by surgery and more trastuzumab with or without pertuzumab for up to 1 year.
If after neoadjuvant therapy, residual cancer is found during surgery, trastuzumab may be changed to a different drug, called ado-trastuzumab emtansine, which is given every 3 weeks for 14 doses.
If hormone receptor-positive cancer is found in the lymph nodes, your doctor might recommend one year of trastuzumab followed by additional treatment with an oral drug called neratinib for 1 year. Stage II cancers are treated with either breast-conserving surgery BCS; sometimes called lumpectomy or partial mastectomy or mastectomy.
Women who have BCS are treated with radiation therapy after surgery. Women who have a mastectomy are typically treated with radiation if the cancer is found in the lymph nodes. Some patients who have a SLNB that shows cancer in a few lymph nodes may not have the rest of their lymph nodes removed to check for more cancer.
In these patients, radiation may be discussed as a treatment option after mastectomy. If you were initially diagnosed with stage II breast cancer and were given treatment such as chemotherapy or hormone therapy before surgery, radiation therapy might be recommended if cancer is found in the lymph nodes at the time of the mastectomy. A doctor who specializes in radiation, called a radiation oncologist , may review your case to discuss whether radiation would be helpful to you.
In some cases, breast reconstruction can be done during the surgery to remove the cancer. But if you will need radiation after surgery, it is better to wait to get reconstruction until after the radiation is complete. Systemic therapy is recommended for some women with stage II breast cancer.
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