Chemotherapy
Chemotherapy drugs kill or disable cancer cells.
Chemotherapy is a treatment option for most breast cancers.
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 team may be able to treat or prevent many side effects. Or they may be able to 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).
Neoadjuvant chemotherapy may also be given to people who have enlarged lymph nodes in the underarm area due to the spread of breast cancer to these lymph nodes. Neoadjuvant therapy can shrink the lymph nodes. This makes it easier to remove the nodes during surgery.
People with some locally advanced breast cancers, including inflammatory breast cancer, begin treatment with neoadjuvant chemotherapy to reduce the size of the tumor in the breast and lymph nodes, to make 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.
Click on the topics below to learn more.
Questions you may want to ask your health care provider
- Why do you recommend chemotherapy for me?
- What chemotherapy drugs do you recommend? Why have you chosen these drugs for me?
- Is there a clinical trial I can join?
- 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?
- What are my chances of survival? How does this compare to survival with other treatment options, including a plan without chemotherapy?
- 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 through an IV into a vein?
- 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 a cold cap) 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 team.
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 take 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 are 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 increase survival and reduce cancer-related symptoms.
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 make sure high-quality care is given. 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 follow.
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 has risks and benefits to consider along with your own values and lifestyle.
Financial assistance
Costs related to breast cancer treatment can quickly become a financial burden for you and your family. Dealing with finances and insurance can be overwhelming.
Most chemotherapy drugs are given through an IV into a vein, so they are covered under your health insurance plan’s medical benefit. However, some chemotherapy drugs are pills and are covered under your plan’s prescription drug benefit.
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 prescription drugs.
Many cancer centers have 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. To learn more about this program and other helpful resources, call the Komen Patient Care Center at 1-877 GO KOMEN (1-877-465-6636) or email helpline@komen.org. Se habla español. |
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Susan G. Komen®‘s position on fairness in oral cancer drug coverage |
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Insurance coverage of oral cancer drugs Cancer medications given through an IV into a vein or by an injection (under the skin or into a muscle) are usually covered under a health insurance plan’s medical benefit. However, oral cancer drugs (cancer medications that are pills) 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 for 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 oral drug coverage parity at the state or national level. |
You’re not alone
It’s normal to feel worried or scared about going through chemotherapy 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 and are living their lives.
It may be helpful for you to talk about how you’re feeling and get support from others. Having people in your life who can relate to some of what you’re going through may help you feel less alone.
You could share your experience and advice with others going through chemotherapy or those who’ve finished treatment. You can do this in a support group or by connecting one-on-one with another breast cancer survivor. A social worker or patient navigator can help you find these resources.
You can also talk with your health care providers about how you’re coping. They care about your overall well-being and want to help. They may connect you to a mental health provider on your health care team, such as a social worker, for emotional support.
Emotional health after chemotherapy
After chemotherapy ends, you may feel some common emotions. Any anxiety you might have had about getting through chemotherapy could have eased, but you may be worried about what happens next. You may also feel a sense of relief about completing this part of your treatment. This is all normal.
Make sure you take time to recover both physically and emotionally. You may want to have family and friends available for support.
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 |
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Updated 02/25/25
This content is regularly reviewed by an expert panel including researchers, practicing clinicians and patient advocates.
