by EBSCO Medical Review Board

Chemotherapy (chemo) uses drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body. It may be used:

  • Before surgery—to shrink the tumor
  • After surgery—to kill cells that are left behind
  • To help ease symptoms caused by the tumor

Chemo may also be used with other therapies. This may include radiation treatment, biologic therapy, targeted therapy, or hormone blocking therapy.

Chemotherapy Drugs and Delivery

There are many kinds of chemo drugs. The drugs and how they are used will depend on the type of cancer. Breast cancer may be treated with:

  • Cyclophosphamide, methotrexate, and 5-fluorouracil (CFM)
  • Cyclophosphamide, doxorubicin, and fluorouracil (CAF)
  • Doxorubicin and cyclophosphamide (AC)
  • Doxorubicin and cyclophosphamide followed by paclitaxel, docetaxel concurrent with AC, or docetaxel (TAC)
  • Doxorubicin, followed by CMF
  • Docetaxel and cyclophosphamide (TC)
  • Cyclophosphamide, epirubicin, and fluorouracil with or without docetaxel

Chemo is most often given through an IV. It is done in cycles over a set time.

Side Effects and Management

Chemo can cause a range of side effects. The most common are:

  • Nausea or vomiting
  • Feeling very tired
  • Hair loss
  • Problems with memory or thinking clearly
  • Low blood cell counts (red cells, white cells, or platelets)—can lead to infection or bleeding
  • Premature menopause—including symptoms and loss of fertility

Long term effects may include heart muscle damage (doxorubincin) and rarely, leukemia.

There are many ways to manage these problems. Medicines and lifestyle changes are the most common. In some cases, chemo cycles may be changed. This can lower the risk of serious problems. It is important to talk to the care team as soon as these appear. Addressing problems early can make them easier to control.

References

Breast cancer. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gynecology-and-obstetrics/breast-disorders/breast-cancer. Accessed March 24, 2022.

Breast cancer in women. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/breast-cancer-in-women. Accessed March 24, 2022.

Chemotherapy for breast cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/breast-cancer/treatment/chemotherapy-for-breast-cancer.html. Accessed March 24, 2022.

Chemotherapy for early and locally advanced breast cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/chemotherapy-for-early-and-locally-advanced-breast-cancer. Accessed March 24, 2022.

Chemotherapy for metastatic breast cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/chemotherapy-for-metastatic-breast-cancer. Accessed March 24, 2022.

Fisusi FA, Akala EO. Drug combinations in breast cancer therapy. Pharm Nanotechnol. 2019;7(1):3-23.

Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/breast/patient/breast-treatment-pdq#section/%5F185. Accessed March 24, 2022.

Revision Information