Chemotherapy for early breast cancer

To treat early breast cancer, chemotherapy can be used after or before breast cancer surgery.

Chemotherapy after breast surgery 

Chemotherapy is often used after surgery (‘adjuvant chemotherapy’) for early breast cancer. It reduces the risk that the cancer will return or spread. You may have chemotherapy in combination with other treatments, such as Herceptin.

Chemotherapy before breast surgery 

Chemotherapy can be used before surgery (‘neoadjuvant chemotherapy’). The aim of neoadjuvant therapy is to:

• slow the growth of a fast-growing breast cancer
• shrink a large tumour so the operation can be smaller, such as lumpectomy instead of mastectomy

You are more likely to have chemo before surgery if you have:

• triple negative breast cancer
• HER2-positive breast cancer
• inflammatory breast cancer

Read about neoadjuvant therapy.

Types of chemotherapy drugs

Several different types of chemotherapy are used to treat early breast cancer.

You may have one drug or a combination of drugs. The most effective chemotherapy treatment plans or regimens use more than one drug.

The drug or drugs your doctors recommend for you depend on:

• the other treatments you are having
• the type, stage and grade of your breast cancer
• any other health conditions you have
• your age.

There are several groups or ‘classes’ of chemotherapy drugs. All of them kill cancer cells by damaging the cells or stopping them from dividing. But each group works in a slightly different way, so they have different side effects.

The main groups, or classes, of chemotherapy to treat early breast cancer are:

• anthracyclines such as epirubicin, doxorubicin (Adriamycin)
• mitotic inhibitors such as taxanes, e.g. paclitaxel (Taxol), docetaxel (Taxotere)
• antimetabolites such as 5-fluorouracil (5FU), methotrexate
• alkylating agents such as cyclophosphamide (Cytoxan), carboplatin (Paraplatin).

When you have a combination of chemotherapy drugs, you may see it described using letters such as ‘AC’. These letters are the initials of the drugs being used. For example, AC chemotherapy is a combination of Adriamycin and cyclophosphamide.

Length of treatment

The cycles of treatment are different for everyone. They depend on factors including the type and subtype of breast cancer. The most common treatment for early breast cancer is chemotherapy once every 2 weeks for 4 cycles, then once a week for 12 weeks. 

To understand the cycles of treatment, read About chemotherapy.

Side effects of chemo

Talk to your treating team if you are concerned about any possible chemotherapy side effects. Find out about chemotherapy side effects and how to reduce them.