Chemotherapy for Breast Cancer

Chemotherapy uses drugs to kill cancer cells. It may be given to women with Stage I, II, III, or IV breast cancer. Chemotherapy may be given before or after surgery.
The drugs for breast cancer are usually given directly into a vein (intravenously) through a thin needle or as a pill. You may receive a combination of drugs.
You may receive chemotherapy in a clinic, at the doctor's office, or at home. It's unusual for a woman to need to stay in the hospital during treatment.
The side effects depend mainly on which drugs are given and how much. Chemotherapy kills fast-growing cancer cells, but the drugs can also harm normal cells that divide rapidly:

• Blood cells: When drugs lower the levels of healthy blood cells, you're more likely to get infections, bruise or bleed easily, and feel very weak and tired. Your health care team will check for low levels of blood cells. If your levels are low, your health care team may stop the chemotherapy for a while or reduce the dose of the drug. There are also medicines that can help your body make new blood cells.
• Cells in hair roots: Chemotherapy may cause hair loss. If you lose your hair, it will grow back after treatment, but the color and texture may be changed.
• Cells that line the digestive tract: Chemotherapy can cause a poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Your health care team can give you medicines and suggest other ways to help with these problems.

Some drugs used for breast cancer can cause tingling or numbness in the hands or feet. This problem often goes away after treatment is over.
Other problems may not go away. For example, some of the drugs used for breast cancer may weaken the heart. Your doctor may check your heart before, during, and after treatment. A rare side effect of chemotherapy is that years after treatment, a few women have developed leukemia (cancer of the blood cells).
If you have not yet gone through menopause, some anticancer drugs may damage the ovaries and cause hot flashes, vaginal dryness, and other menopause symptoms. Your menstrual periods may no longer be regular or may stop, and you may lose the ability to become pregnant. The older you are, the more likely that this damage to the ovaries will be permanent. Women who may want to get pregnant later on should ask their health care team about ways to preserve their eggs before treatment starts.
On the other hand, other anticancer drugs don't damage the ovaries and you may remain able to become pregnant during chemotherapy. Before treatment begins, talk with your doctor about birth control because many anticancer drugs given during the first trimester are known to cause birth defects.