Adjuvant chemotherapy

Chemotherapy attempts to destroy cancer cells with drugs. The drugs are a systemic treatment, meaning they get into the bloodstream and affect the whole body. Chemotherapy can attack cells at the original cancer site and any cancer cells that may have spread to another part of the body.

Chemotherapy after surgery is called adjuvant therapy. (Neoadjuvant chemotherapy is chemotherapy before surgery). Depending on your node status, tumor size and type you may not require both chemotherapy and radiation therapy. Your medical oncologist or radiation oncologist will provide information on the benefits of radiation therapy after chemotherapy based on your particular case.

Chemotherapy is more effective in some cases than in others. It is important for you to understand the effectiveness of chemotherapy for your age group and cancer type. If you plan on becoming pregnant you will want to understand what effects chemotherapy may have on your fertility.

Chemotherapy is indicated in the following patients:

  • Node positive patients (regardless of receptor status)
  • HER2 +
  • TNBC
  • Young women under 40

Chemotherapy drugs are typically given in combination, two or three different drugs at the same time. These combinations are called regimens. You may want to ask your physician if you are eligible for more than one regimen and, if so, what are the pluses and minuses associated with each one (e.g., clinical outcomes, side effects). Again, your eligibility for different therapies will depend on your hormonal receptor status and other tumor factors.

In some cases, ONCOTYPE DX can be ordered for your tumor. This test evaluates the genes in your tumour and provides a recurrence score. This score indicates whether or not you would benefit from chemotherapy and greatly helps in your decision making as to whether or not you want to proceed with chemotherapy when you have an ER/PR + tumor that is NODE NEGATIVE.

The most commonly used drug combinations are:

  • CMF: cyclophosphamide (Cytoxan®), methotrexate, and 5-fluorouracil (fluorouracil, 5-FU)
  • CAF (or FAC): cyclophosphamide, doxorubicin (Adriamycin®), and 5-fluorouracil
  • AC: doxorubicin (Adriamycin) and cyclophosphamide12
  • EC: epirubicin (Ellence®) and cyclophosphamide
  • TAC: docetaxel (Taxotere®), doxorubicin (Adriamycin), and cyclophosphamide
  • AC → T: doxorubicin (Adriamycin) and cyclophosphamide followed by paclitaxel
  • (Taxol®) or docetaxel (Taxotere). Trastuzumab (Herceptin) may be given with the paclitaxel or docetaxel for HER2/neu positive tumors.
  • A → CMF: doxorubicin (Adriamycin), followed by CMF
  • CEF (FEC): cyclophosphamide, epirubicin, and 5-fluorouracil (this may be followed by docetaxel)
  • TC: docetaxel (Taxotere) and cyclophosphamide
  • TCH: docetaxel, carboplatin, and trastuzumab (Herceptin) for HER-2 positive tumors

Cancer Basics: How chemotherapy works

Learn more about specific chemotherapies, biological therapies, hormonal therapies and other breast cancer treatment drugs.

Will I need Chemotherapy for My Breast Cancer?

Learn more about chemotherapy and when it is necessary to treat breast cancer.

next steps:

Welcome to the BTC Treatment Decision ToolHave you or someone you love recently received a diagnosis of breast cancer?

Whether you received a diagnosis yesterday or three months ago, you are likely dealing with an upheaval in your life as you’ve known it. Perhaps you have also started the process of meeting with your doctors to discuss what treatment options are available, and which therapies (or combination of therapies) will be the best for you. It is a lot of information to sort through and make sense of.

So we’re here to help.

The team at Be the Choice are a diverse group of women and men who have had experiences with a breast cancer diagnosis and treatment. Some of us have undergone treatment for breast cancer, some of us have provided care for a loved one who has been through treatment, and some of us are physicians and other health care professionals who provide treatment to breast cancer patients.

United in our concern that all people who receive a diagnosis of breast cancer should have access to comprehensive, state-of-the-art treatment information in a comfortable and user-friendly format, we designed this interactive treatment decision tool.

How to use:

Your diagnosis of breast cancer has come with an assessment of your unique clinical and hormonal characteristics. These should be carefully discussed with your medical team and deliberated carefully in advance of any treatment decisions.

This tool will enable you to get to know the “big picture” as well as the “individual picture” behind any breast cancer treatment decision, and to become an active participant in determining your own treatment process. You are the ultimate decision-maker in this process. We hope that you will use the information on this website to inform and empower yourself.

What this tool is not designed to do is deliver individual treatment recommendations. It should be used as a way to get a sense of the full range of treatments available to you as well as what your own treatment plan might look like given your unique profile.