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Neoadjuvant and Adjuvant Chemotherapy

What is neoadjuvant chemotherapy?

Neoadjuvant chemotherapy refers to medicines that are administered before surgery for the treatment of breast cancer. Your doctors may recommend neoadjuvant chemotherapy due to the size of the tumor, since the drugs may shrink the tumor and give you more surgical options.

In some cases, a woman who would have needed a mastectomy due to the large size of her tumor can become a candidate for lumpectomy by shrinking the invasive tumor prior to surgery. Neoadjuvant chemotherapy is also performed for certain types of breast cancer, such as inflammatory breast cancer.

What is adjuvant chemotherapy?

Adjuvant (meaning “in addition to”) chemotherapy refers to medicines administered after surgery for the treatment of breast cancer. Adjuvant chemotherapy is designed to prevent recurrence of the disease, particularly distant recurrence. Your doctors may recommend chemotherapy if your breast cancer is invasive, has unfavorable prognostic factors, is a certain size, or has spread to nearby lymph nodes. It also may be recommended if you are relatively young at the time of diagnosis.

How is chemotherapy administered?

Chemotherapy is usually administered intravenously and given to patients in an outpatient setting. There are some drugs that can be given orally. Some protocols call for a cycle of treatment every three weeks; others may be more frequent. Most women undergoing chemotherapy will have treatment for three to six months. Many women undergoing chemotherapy are able to work while receiving treatment, only missing a few days from work at a given time.

Your medical oncologist takes measures to help reduce and prevent side effects from the drugs, most commonly gastrointestinal side effects such as nausea. Each drug has different potential side effects, so patients should ask for information about their drugs. Hair loss is a common side effect for many chemotherapies, so we encourage patients to prepare in advance for this. Lots can be done with wigs, hats, and bandanas to hopefully reduce how hard this can be for some women. Speak with your medical team for suggestions. Red and white blood cells are also affected by chemotherapy, so exposure to people with colds or flu should be limited.

Request written information about each drug so that you can know how these drugs will affect your daily life and what can be done to minimize side effects. Patients at our Breast Center are invited to attend a chemotherapy class, and they receive one-on-one education about the medicines being prescribed.