The Who, What, Where, When and Sometimes, Why.

Chemotherapy

Chemotherapy drugs kill or disable cancer cells.

Chemotherapy is a treatment option for most types of breast cancer.

The decision to use chemotherapy is based on the tumor stage and certain tumor characteristics (such as hormone receptor status), as well as your age, overall health and personal preferences.

Chemotherapy for early and locally advanced breast cancer

After breast surgery (adjuvant chemotherapy)

For those with early breast cancer, chemotherapy is usually given after breast surgery (called adjuvant chemotherapy), but before radiation therapy.

Adjuvant chemotherapy helps lower the risk of breast cancer recurrence by getting rid of cancer cells that might still be in the body. These cells are too small to see on scans or to measure with lab tests.

Learn more about getting chemotherapy.

Before breast surgery (neoadjuvant chemotherapy)

Sometimes, chemotherapy is used before surgery (called neoadjuvant or preoperative chemotherapy).

In women with large tumors who need a mastectomy, neoadjuvant chemotherapy may shrink the tumor enough so a lumpectomy becomes an option.

In women with locally advanced breast cancer, neoadjuvant chemotherapy can reduce the size of the tumor in the breast and/or in the lymph nodes, and make it easier to surgically remove the cancer.

Learn more about neoadjuvant chemotherapy.

 

Chemotherapy usually lasts 3-6 months, but you have days or weeks off between treatments.

Your treatment schedule depends on the combination of drugs given.

Learn how chemotherapy is given and what to expect at each chemotherapy session

Learn about chemotherapy drugs.

There are many effective chemotherapy drugs. Often, a combination of 2 or 3 chemotherapy drugs is used.

Learn about chemotherapy drugs.

Chemotherapy has many common side effects.

Most side effects occur during treatment and begin to go away shortly after treatment ends. Others can last for months or even years.

Learn about easing worries over side effects of chemotherapy.

Learn about short-term side effects of chemotherapy.

Learn about long-term side effects of chemotherapy.

Research is ongoing to improve chemotherapy. New drugs and ways to help guide chemotherapy decisions are under study in clinical trials. 

Learn about emerging areas in chemotherapy for early and locally advanced breast cancer.

Learn about emerging areas in treatment for metastatic breast cancer.

Learn about clinical trials.

  • Why do you recommend chemotherapy for me?
  • What chemotherapy drugs do you recommend? Why have you chosen these drugs for me?
  • What are my chances of a local breast cancer recurrencemetastasis or a new breast cancer with these chemotherapy drugs? Please explain the differences to me.
  • What are my chances of survival? How does this compare to survival with other treatment options, including a plan without chemotherapy?
  • Is there a clinical trial I can join?
  • Will I need other treatments besides chemotherapy?
  • What were the estrogen receptor status and progesterone receptor status of my tumor? How do these affect my treatment plan?
  • What was the HER2 status of my tumor? How does this affect my treatment plan?
  • Was cancer found in my lymph nodes? How many nodes had cancer? How does this affect my treatment plan?
  • Should I have chemotherapy even if my lymph nodes don’t have cancer?
  • Are there other tests such as Oncotype DX®, MammaPrint® or PAM50 (Prosigna®) that could or should be done on my tumor to help decide whether I should have chemotherapy?
  • In what form and how often will the chemotherapy be given? How many treatment sessions will I have? How long will each treatment session take?
  • Will I need someone to come with me to the treatment sessions? Will someone need to drive me home?
  • What are the side effects and long-term health risks of chemotherapy?
  • Which side effects should I report to you right away?
  • What medications will you give me to help reduce the side effects of chemotherapy? How and when should I take them?
  • What do I need to consider before treatment begins if I would like to have a child after being treated for breast cancer?
  • If I lose my hair during chemotherapy, where can I buy a wig? When should I do this? How do I get reimbursed from my insurance company?
  • Can I continue to work, exercise and do other routine activities while on chemotherapy? Are there special precautions I should take while on chemotherapy or afterwards?
  • Can I have sex while on chemotherapy?
  • Are there any medications or complementary therapies I should avoid during my treatment?
  • Should I continue to see my regular physician or gynecologist during my treatment?
  • Where can I find a support group for people diagnosed with breast cancer (or cancer in general)?
  • How often will I have check-ups and follow-up tests after treatment ends?
  • Will a follow-up care plan be prepared for me?
  • Which health care provider is in charge of my follow-up care?
  • Who will talk with me about the cost of my treatment (including the expenses covered by my insurance and the costs I should expect to pay out-of-pocket)?

Learn more about talking with your health care provider.

It may be helpful to download and print Susan G. Komen®‘s Questions to Ask Your Doctor About Chemotherapy and Side Effects resource and take it with you to your next doctor appointment. There’s plenty of space to write down the answers to these questions, which you can refer to later.

There are other Questions to Ask Your Doctor resources on many different breast cancer topics you may wish to download. They are a nice tool for people recently diagnosed with breast cancer, who may be too overwhelmed to know where to begin to gather information.

 

Chemotherapy for metastatic breast cancer

For those with metastatic breast cancer, chemotherapy is used to kill cancer cells that have spread from the breast to other parts of the body.

Chemotherapy can reduce cancer-related symptoms and increase survival.

Learn more about treatment for metastatic breast cancer.

 

Treatment guidelines

Although the exact treatment for breast cancer varies from person to person, guidelines help ensure high-quality care. These guidelines are based on the latest research and agreement among experts.

The National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) are respected organizations that regularly review and update their guidelines.

In addition, the National Cancer Institute (NCI) has treatment overviews.

Talk with your health care providers about which treatment guidelines they use.

Importance of following your breast cancer treatment plan

Breast cancer treatment is most effective when all parts of the treatment plan are followed as prescribed.

It’s important to follow the treatment plan (for medications and other therapies) prescribed by your health care provider in terms of:

  • Timing
  • Dose
  • Frequency

Completing chemotherapy

Although most side effects go away shortly after chemotherapy ends, preventing or treating symptoms can help you complete your course of chemotherapy.

Don’t feel you have to endure side effects, such as nausea. Talk with your health care provider about any side effects you have.

Your provider may be able to prescribe medications to treat your side effects or change your treatment plan to reduce them.

Learn more about the side effects of chemotherapy.

Learn more about the importance of following your breast cancer treatment plan.

Completing intravenous (IV) chemotherapy

Most chemotherapy drugs for breast cancer are given by vein (through an IV) in an outpatient setting at a hospital or clinic.

Getting to and from the hospital or clinic can be hard, especially if you live far away.

If you need a ride to and from treatment or have child care or elder care needs that make getting to treatments difficult, there may be resources available.

Family and friends often want to help, but don’t know how. These may be ways for them to get involved. It’s OK to ask for help.

Sometimes, there are programs that help with local or long-distance transportation and lodging (if you need a place to stay overnight during treatment).

There are also programs that help with child care and elder care costs.

Learn more about the importance of following your breast cancer treatment plan.

Completing oral chemotherapy

A few breast cancer chemotherapy drugs are pills.

If you have trouble remembering to take oral chemotherapy or medications to treat side effects, a daily pillbox or setting an alarm on your watch or mobile device (you may be able to download an app) may help [1].

Learn more about the importance of following your breast cancer treatment plan.

 

Prescription drug assistance

Chemotherapy drug costs can quickly become a financial burden for you and your family.

Medicare and many insurance companies offer prescription drug plans. One may already be included in your policy or you may be able to buy an extra plan for prescriptions.

Some drugs are off-patent and may have a generic form. Generic drugs cost less than the name brands, but are just as effective.

You may also qualify for programs that help with drug costs or offer low-cost or free prescriptions.

Learn more about insurance plans and prescription drug assistance programs.

Learn more about other financial assistance programs.

Susan G. Komen®‘s position on fairness in oral cancer drug coverage

Although most chemotherapy is given by vein (through an IV), a few chemotherapy drugs are pills (oral chemotherapy).

Insurance coverage of oral cancer drugs

Insurance policies haven’t kept pace with treatment advances. IV chemotherapy is usually covered under a health insurance plan’s medical benefit, but oral chemotherapy is usually covered under a plan’s prescription drug benefit.

As a result, people often find themselves facing high out-of-pocket costs when filling prescriptions for oral chemotherapy. Sometimes this can cost thousands of dollars a month.

The impact of high drug costs

High prescription drug costs are a barrier to care. They can prevent people from getting the medications prescribed by their health care providers.

No one should be forced to get less appropriate treatment because an insurer gives more coverage for IV chemotherapy than oral chemotherapy.

Efforts to increase fairness in drug coverage

Komen supports state and federal efforts to require insurers to provide the same or better coverage for oral chemotherapy as they do for IV chemotherapy. This would help ensure patients have access to affordable, appropriate treatment.

Take action

Ask your U.S. representative to co-sponsor the Cancer Drug Parity Act.

 

 

Komen Treatment Assistance Program

Susan G. Komen® offers the Komen Treatment Assistance Program to help eligible, underserved breast cancer patients in treatment. To learn more about this program and other helpful resources, call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636).

 

You are not alone

If you are facing chemotherapy, remember, many people have been where you are today. They had the same fears. They’ve gone through breast cancer treatment, recovered and are living their lives.

Sharing experiences and advice with others going through chemotherapy or those who’ve finished treatment may help.

Our Support section offers a list of resources to help find local and online support groups. Your health care provider may also be able to help you find a local support group.

Learn more about social support and support groups.

 

SUSAN G. KOMEN® SUPPORT RESOURCES

  • If you or a loved one needs more information about breast health or breast cancer, call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636). All calls are answered by a trained specialist or oncology social worker in English and Spanish, Monday through Friday from 9:00 a.m. to 10:00 p.m. ET. You can also email the helpline at helpline@komen.org.
  • We offer an online support community through our closed Facebook Group – Komen Breast Cancer group. The Facebook group provides a place where those with a connection to breast cancer can discuss each other’s experiences and build strong relationships to provide support to each other. Visit Facebook and search for “Komen Breast Cancer group” to request to join the closed group.
  • Komen Affiliates offer breast health education and some fund breast cancer programs through local community organizations. Your local Affiliate may also help you find breast cancer resources in your area. Find your local Affiliate.
  • Our fact sheets, booklets and other education materials offer additional information.