Chemotherapy is a common medical treatment used to treat breast cancer. However, not every patient with breast cancer will need chemotherapy while others may receive chemotherapy in combination with other types of drug treatments, surgery, and/or radiation.
New research is beginning to emerge that questions the need for chemotherapy in patients with specific types of breast cancer. At Rocky Mountain Cancer Centers, our physicians are actively engaged in clinical trials and stay updated on the latest research-based treatment advances.
Depending on many unique factors, such as what type of breast cancer you have and its stage, your age, family history, and overall health, your Rocky Mountain Cancer Centers oncologist will recommend a personalized treatment plan that may include chemotherapy, radiation therapy, hormone therapy, targeted therapy, surgery, or a combination of two or more of these treatments. On this page, we explain the drug-based treatments for breast cancer, including chemotherapy, targeted therapy, hormone therapy and immunotherapy.
How is chemo used to treat breast cancer
Chemotherapy is the use of powerful drugs that kill cancer cells. If your treatment plan includes chemotherapy, there are different ways in which we might use it:
- Before surgery. In some cases, chemo for breast cancer is administered before surgery —called neoadjuvant chemotherapy — to shrink a tumor so it can be more easily removed. This technique may be used so a woman can have a lumpectomy (surgery to remove only the tumor and surrounding tissue) rather than a mastectomy (removal of the entire breast).
- After surgery. Most commonly, chemotherapy is given after surgery to kill any remaining cancer cells that were too small to be detected or traveled to other parts of the body. When chemotherapy is administered after surgery, it’s called adjuvant chemotherapy, and its purpose is to reduce the risk of the cancer spreading or returning.
- Primary treatment. We often will recommend chemotherapy as the primary or only treatment in advanced breast cancers that have spread (metastasized) to other parts of the body outside the breast and armpit.
Types of chemo for breast cancer
There are many different types of chemotherapy used for treating breast cancer. Most are given intravenously at Rocky Mountain Cancer Centers. One or a combination of drugs may be used. New drugs are being developed regularly, so the types of chemo used for breast cancer can change.
Breast cancer differs by individual, so your Rocky Mountain Cancer Centers oncologist will look at many factors in determining the type of chemo drugs to use and also the schedule and frequency with which you will receive them. To develop a personalized treatment plan, we consider:
- Characteristics of your cancer: This includes the size and stage of your cancer as well as specific genetic characteristics, such as hormone-receptor status and HER2 status.
- Health history. Your age, menopausal status, and overall health including chronic health conditions.
In addition, your physician may conduct genetic testing, such as tumor molecular profiling, to test for sensitivity to specific chemotherapy drugs. Your physician also will consider which types of drugs work best together and develop a plan so that if one drug stops working, there are alternatives available.
Other types of medical treatments for breast cancer
In addition to traditional chemotherapy for breast cancer, your cancer care team at Rocky Mountain Cancer Centers may recommend additional types of medicines to treat your cancer. These can include:
- Targeted Therapies: Targeted therapies are drugs designed to identify and attack only specific cancer cells to stop them from growing or spreading. If your breast cancer tests positive for the HER2 receptors, Rocky Mountain Cancer Centers offers several different types of targeted therapies that work in various ways, including:
- Drugs that block the cancer cells’ ability to receive the signals that tell them to grow.
- Drugs that work by attaching a chemotherapy agent to another drug, which then carries the chemotherapy drug to the HER2-positive cancer cells.
- Drugs that prevent certain proteins from triggering uncontrolled cancer cell growth.
- Hormone Therapies: About two out of three breast cancers are hormone receptor positive. This means that the cancer cells have receptors that attach to estrogen and/or progesterone to grow. Hormone therapies work by lowering the estrogen levels in your body or preventing hormones from helping the cancer cells to grow. The most well-known hormone therapy for breast cancer is Tamoxifen, but there are other drugs and another class of hormone therapy called aromatase inhibitors available. Sometimes another oral agent called CDK 4/6 inhibitors can be used together with aromatase inhibitors to enhance efficacy.
- Immunotherapy: So far, breast cancer has seemed unresponsive to medical treatments that attempt to use the body’s own immune system to fight the cancer. However, several new clinical studies are testing immunotherapy drugs, particularly in patients with advanced inflammatory breast cancer or metastatic breast cancer that has spread to other parts of the body.
- Other Medications: Medications to increase bone density such as Zometa are used in some patients to promote bone health as well as to improve survival.
Rocky Mountain Cancer Centers are currently participating in several clinical trials of possible new treatments for breast cancer. To learn more about our clinical trials, talk with your physician. A list of current clinical trials can be found here.
How chemotherapy for breast cancer is administered
In addition to deciding what types of chemo will work best for you, your doctor will also determine the regimen you will follow. A regimen includes the frequency and dosages you will receive. The goal of the plan is to use medicines in a regimen that will kill the cancer cells and prevent the cancer cells from learning how to protect themselves, while also balancing the benefits of the drugs with any side effects you might experience.
Chemotherapy for breast cancer is usually administered intravenously at Rocky Mountain Cancer Centers. One or a combination of drugs may be used. Chemo for breast cancer is administered in cycles made up of treatment days and rest days. Depending on the type of drug or drugs being used, your cycle may range from two to three weeks with treatments taking place the first week and then a week or two of rest. Most adjuvant and neoadjuvant chemotherapy for breast cancer is repeated over the course of three to six months. When used as a primary treatment for advanced breast cancer, the number of cycles will depend on how effective the treatment is and how well your body responds.
Some patients with breast cancer will be prescribed oral chemotherapy, which is taken in pill or liquid form. Rocky Mountain Cancer Centers offers an in-house pharmacy where you can fill your prescription quickly and conveniently and get expert advice.
Side effects of chemo for breast cancer
At Rocky Mountain Cancer Centers, we are diligent in our efforts to create personalized treatment plans that maximize the benefits of chemotherapy while minimizing side effects. Your care team will work with you before you start chemotherapy to prepare you for side effects and to start treatment, such as medications, that will reduce the number of side effects or their severity.
Nausea, fatigue, and hair loss are the three side effects of chemotherapy for breast cancer that our patients worry about most. Our specially trained and experienced chemotherapy nurses can help provide measures to combat all three of these. In addition, you can help reduce the impact of side effects by getting adequate rest, eating a healthy diet, and continuing a light level of physical activity. Medications are available to help support sleep and reduce nausea. We also offer scalp cooling , which can minimize the hair loss often caused by chemotherapy for breast cancer.
Because chemotherapy travels throughout the body, side effects tend to be more generalized than with other treatments, such as radiation. Common side effects include:
- Fatigue (Read our blog on fatigue.)
- Chemo brain, which can include feeling forgetful or having trouble concentrating (Read our blog on chemo-brain.)
- Nausea and vomiting
- Hair loss (Read our blog on hair loss.)
- Loss of appetite (Get nutrition tips here.)
- Dry mouth, sore throat, and difficulty swallowing
- Dry skin (Download our skin care flyer.)
- Constipation or diarrhea (Download our flyer.)
Side effects of targeted therapy and hormone therapy are different than those of chemotherapy and tend to be less severe. You can read more about those here.
If you are a patient and are experiencing worsening symptoms from your treatment, such as those listed below, our medical professionals are available 24 hours a day, 7 days a week to help. We can assess signs and symptoms, schedule you for an in-office, same or next day appointment and help you avoid a trip to the Urgent Care, ER or unplanned hospitalization. In the event of a life-threatening emergency always call 911. Call us if you are experiencing:
- Chills or fever greater than 100.4
- Burning with urination, frequency, urgency, lower back pain (UTI)
- Productive cough with green, yellow, red, brown sputum
- Unmanaged diarrhea, constipation, nausea, vomiting
- Unmanaged pain
- Swelling, redness and pain on extremities
- Shortness of breath/chest pain
- Dizziness with changing position or lightheadedness
- Dark urine, less urine than normal, thirst, dry mouth (dehydration)
- Mouth sores, difficulty swallowing, frequent or sever heartburn
- Severe fatigue