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.

It’s normal to worry about possible side effects of chemotherapy, but many can be managed. Your health care provider may be able to treat or prevent many side effects or change your treatment plan to reduce them.

Learn about chemotherapy for metastatic breast cancer.

Chemotherapy for early and locally advanced breast cancer

After breast surgery (adjuvant chemotherapy)

For people 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 chemotherapy 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, making it easier to surgically remove the cancer.

In some cases, response to neoadjuvant therapy can help guide treatment after breast cancer surgery.

Learn more about neoadjuvant chemotherapy.

Learn more about getting chemotherapy.

 

Chemotherapy is usually given over 3-6 months. You will have days or weeks off between treatments to give your body time to recover.

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 for early breast cancer.

Learn about chemotherapy drugs for metastatic breast cancer.

There are many effective chemotherapy drugs. Often, a combination of 2 or 3 chemotherapy drugs is given over 3-6 months.

Learn about chemotherapy drugs for early breast cancer.

Learn about chemotherapy drugs for metastatic breast cancer.

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.

Before you begin chemotherapy, talk with your health care provider about possible side effects and how to manage them.

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 recurrence, metastasis or a new breast cancer with these chemotherapy drugs and my chances without chemotherapy? 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® or MammaPrint® that 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 get a port-a-cath to make it easier to get chemotherapy by vein (through an IV)?
  • When will I begin chemotherapy? Can I choose the days and times of treatment?
  • 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?
  • Are there any complementary therapies that might help reduce some side effects of chemotherapy?
  • Are there any medications or complementary therapies I should avoid during my treatment?
  • What do I need to consider before treatment begins if I would like to have a child after being treated for breast cancer?
  • Are there things I need to do before chemotherapy begins, such as getting a flu shot and taking care of any needed dental work?
  • Will this chemotherapy make me lose my hair? Would scalp cooling (using cold caps) help me prevent some hair loss?
  • 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?
  • Should I continue to see my regular doctor or gynecologist during my treatment?
  • Where can I find information about support groups and other types of support for me and my loved ones?
  • 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.

If you’ve been recently diagnosed with breast cancer or feel too overwhelmed to know where to begin to gather information, Susan G. Komen® has a Questions to Ask Your Doctor About Chemotherapy and Side Effects resource that might help.

You can download and print it to bring with you to your next doctor’s appointment or you can save it on your computer, tablet or phone using an app such as Adobe. Plenty of space and a notes section is provided to write or type the answers to the questions.

There are other Questions to Ask Your Doctor resources on many different breast cancer topics you may wish to download.

 

Chemotherapy for metastatic breast cancer

For people 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, evidence-based 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 team about which treatment guidelines they use.

After you get a recommended treatment plan from your health care team, study your treatment options. Together with your health care team, make thoughtful, informed decisions that are best for you. Each treatment option has risks and benefits to consider along with your own values and lifestyle.

Importance of following your breast cancer treatment plan

It’s normal to worry about possible side effects of chemotherapy, but 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

People who complete their full course of treatment have a higher chance of survival.

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 health care 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 or if others rely on you for care.

If you need a ride to and from treatment, or you have child or elder care needs that make getting to chemotherapy 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 and elder care costs.

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

Find other resources that offer social support and practical support.

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.

Komen Financial Assistance Program

Susan G. Komen® created the Komen Financial Assistance Program to help those struggling with the costs of breast cancer treatment by providing financial assistance to eligible individuals.

Funding is available for eligible individuals undergoing breast cancer treatment at any stage or living with metastatic breast cancer (stage 4).

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) or email helpline@komen.org.

Se habla español.

 

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.

Many cancer centers have patient financial counselors who can discuss insurance and cost coverage with you.

Learn more about insurance plans and prescription drug assistance programs.

Learn more about other financial assistance programs.

Komen Financial Assistance Program

Susan G. Komen® created the Komen Financial Assistance Program to help those struggling with the costs of breast cancer treatment by providing financial assistance to eligible individuals.

Funding is available for eligible individuals undergoing breast cancer treatment at any stage or living with metastatic breast cancer (stage 4).

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) or email helpline@komen.org.

Se habla español.

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

Insurance coverage of oral cancer drugs

Cancer medications given by vein (through an IV) or injection (under the skin or into a muscle) are usually covered under a health insurance plan’s medical benefit. However, cancer medications that are pills (oral cancer drugs) are usually covered under a health insurance plan’s prescription drug benefit.

As a result, people often find themselves facing high out-of-pocket costs when filling prescriptions for oral cancer drugs. Sometimes these costs can be thousands of dollars a month.

The impact of high cost-sharing

High prescription drug costs and the resulting out-of-pocket burden on patients 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 and injectable drugs than pills.

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 cancer drugs as they do for IV and injectable cancer drugs. This would help make sure patients have access to affordable, appropriate treatment.

Become a Komen Advocacy Insider

Sign up to be a Komen Advocacy Insider and get informed when action is needed on drug coverage issues at the state or national level.

You’re not alone

If you’re facing chemotherapy, it’s normal to feel worried or scared about going through treatment and the side effects you may have. You may also be thinking about what your life will be like after you finish treatment. 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. You can do this in a support group or by connecting one-on-one with another breast cancer survivor.

You can also talk with your health care providers about how you’re coping. They care about your overall well-being and can help you find ways to improve it. In addition to suggesting a support group, they may connect you to another member of your health care team, such as a social worker or patient navigator, for support. They may also refer you to a counselor.

Our Support section has a list of resources to help find local and online support groups and other resources.

Learn more about social support and support groups.

Learn about healthy ways to cope with stress

Susan G. Komen® Support Resources

  • Do you need help? We’re here for you. The Komen Patient Care Center is your trusted, go-to source for timely, accurate breast health and breast cancer information, services and resources. Our navigators offer free, personalized support to patients, caregivers and family members, including education, emotional support, financial assistance, help accessing care and more. Get connected to a Komen navigator by contacting the Breast Care Helpline at 1-877-465-6636 or email helpline@komen.org to get started. All calls are answered Monday through Thursday, 9 a.m to 7 p.m. ET and Friday, 9 a.m. to 6 p.m. ET. Se habla español.
  • The Komen Breast Cancer and Komen Metastatic (Stage IV) Breast Cancer Facebook groups are places where those with breast cancer and their family and friends can talk with others for friendship and support.
  • Our fact sheets, booklets and other education materials offer additional information.

Updated 12/28/23

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Questions to Ask Your Doctor

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