Chemotherapy for Breast Cancer: What to Expect

If chemotherapy has been recommended as part of your breast cancer treatment, it is natural to have questions and concerns. This video explains how chemotherapy works, when it may be used, and what you can expect during your treatment journey. Chemotherapy uses anti-cancer drugs to destroy cancer cells throughout the body. These drugs work by disrupting how cancer cells grow and divide. Because chemotherapy travels through your bloodstream, it can reach cancer cells that may have spread beyond the breast, helping to reduce the risk of the cancer returning. Chemotherapy may be given before or after surgery, depending on your individual situation. Your oncologist will explain which approach is most appropriate for you and discuss the potential benefits for your specific diagnosis. Chemotherapy before surgery is called 'neo-adjuvant' treatment. It may be recommended if your cancer is large, fast-growing, or has spread to the lymph nodes. This approach aims to shrink the tumour, making surgery more straightforward, and sometimes allowing breast-conserving surgery rather than mastectomy. Chemotherapy after surgery is called adjuvant treatment. It aims to destroy any remaining cancer cells and reduce the risk of the cancer coming back. Your oncologist may recommend this if there are factors that suggest a higher risk of recurrence. Chemotherapy is usually given in cycles, with treatment sessions followed by rest periods to allow your body to recover. Each cycle typically lasts one to three weeks. Most people have their treatment as an outpatient, meaning you can go home the same day after each session. It is also possible to have some chemotherapy treatment delivered at home. The drugs are usually given into a vein, either through a small tube in your hand or arm, or through a longer-term device such as a PICC line or portacath. This is placed as a small button under your skin as a minor operation, but allows blood to be taken and drugs given easily without having to repeatedly insert a drip in the arm. Your team will explain which method is most suitable for your treatment plan. Several different chemotherapy drugs are used for breast cancer - often in combination. The specific drugs recommended for you will depend on your cancer type; stage; and overall health, and your oncologist will discuss the options with you. Chemotherapy can cause side effects because it affects some healthy cells as well as cancer cells. Common side effects may include tiredness, nausea, hair loss, and increased risk of infection. However, these are usually temporary and can often be well managed with supportive medications, and care from your clinical team. Your clinical team will monitor you closely throughout treatment. Before each cycle, blood tests check that your body has recovered sufficiently to continue. Some patients will receive additional medication to boost their immune system depending on blood test results. If you experience any concerning symptoms between appointments, such as fever or unusual bleeding, contact your team immediately for advice. If you have HER2-positive breast cancer, you may also receive targeted therapy drugs alongside chemotherapy. These work in a different way, specifically blocking proteins that help cancer cells grow, and have improved outcomes significantly. Most side effects gradually improve after treatment ends, though some may take several months to fully resolve. Your team will provide guidance on managing any ongoing effects and support your recovery, and many people return to their normal activities within a few weeks. Understanding chemotherapy can help you feel more prepared and in control. If you have questions about your treatment plan, please speak to your oncologist or breast care nurse - your team is there to support you at every stage.