Breast cancer is one of the most common cancers in women. Chemotherapy is used to kill cancer cells, shrink tumors, prevent recurrence, and treat cancer that has spread to other parts of the body. The choice of chemotherapy depends on tumor type, stage, hormone receptor status, and HER2 expression.
Types of Breast Cancer
- Hormone receptor-positive (ER/PR+)
- HER2-positive
- Triple-negative breast cancer (TNBC)
Goals of Chemotherapy
- Reduce tumor size before surgery (neoadjuvant)
- Eliminate remaining cancer cells after surgery (adjuvant)
- Treat advanced or metastatic cancer
- Improve survival and reduce recurrence risk
Common Chemotherapy Regimens for Breast Cancer
1. Anthracycline-Based Regimens
- Doxorubicin + Cyclophosphamide (AC)
- FAC regimen: 5-FU + Doxorubicin + Cyclophosphamide
2. Taxane-Based Regimens
- Paclitaxel
- Docetaxel
Often used after anthracyclines to improve treatment outcomes.
3. Combination Regimens
- AC → T (Doxorubicin + Cyclophosphamide followed by Taxane)
- TC (Docetaxel + Cyclophosphamide)
Targeted Therapy in Breast Cancer
HER2-Positive Breast Cancer
- Trastuzumab
- Pertuzumab
- Ado-trastuzumab emtansine (T-DM1)
These drugs specifically target the HER2 protein and are used along with chemotherapy.
Hormonal Therapy in Breast Cancer
Used in hormone receptor-positive cancers.
Premenopausal Women
- Tamoxifen
Postmenopausal Women
- Aromatase inhibitors: Letrozole, Anastrozole, Exemestane
Ovarian Suppression Therapy
- Goserelin
- Leuprolide
Immunotherapy (for TNBC)
- PD-1/PD-L1 inhibitors
- Atezolizumab + nab-Paclitaxel
Side Effects of Breast Cancer Chemotherapy
- Nausea and vomiting
- Hair loss
- Fatigue
- Low blood counts (neutropenia)
- Infections
- Nail changes
- Peripheral neuropathy (taxanes)
- Cardiotoxicity (anthracyclines)
Supportive Care
- Anti-emetics for nausea
- Growth factors for low white blood cells
- Pain management
- Nutritional support
- Monitoring heart function during anthracycline therapy
Patient Counseling
- Follow chemotherapy schedule strictly
- Report fever, bleeding, or breathlessness immediately
- Maintain a balanced diet and stay hydrated
- Hair loss is temporary—hair will regrow
- Avoid pregnancy during treatment
- Regular heart monitoring if receiving trastuzumab or anthracyclines
Detailed Notes:
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