Reviewed by: HU Medical Review Board | Last reviewed: June 2023

Chemotherapy is a type of systemic treatment in which drugs are used to kill cancer cells. Systemic treatments work by treating the whole body. Chemotherapy drugs may be used in combination with other drugs or as a single agent (called monotherapy).1

In metastatic breast cancer, sequential single agents are usually recommended. This method uses 1 chemotherapy drug at a time, 1 after another. The drug is then changed to another when the breast cancer no longer responds or begins growing. It may also be changed if the person can no longer tolerate the specific drug.2

Chemotherapy may be prescribed at different points in the treatment process. It may be used to eliminate or control breast cancer. Chemotherapy drugs may be given as:1,3

  • An injection
  • Tablet/capsule form
  • Intravenous (IV) infusion

The frequency and dosage depend on each person and the specific medicines chosen.1,3

When chemotherapy is used to treat breast cancer

Chemotherapy may be used as an adjuvant treatment (after primary therapy) in early breast cancers to reduce the risk of cancer coming back (recurrence). In some cases, chemotherapy may also be used before surgery to reduce the size of a tumor.1,2

In advanced or metastatic breast cancer, chemotherapy may be the primary treatment. It may be used along with certain targeted therapies or immunotherapies.1,2

How does chemotherapy work?

Cancer occurs when there are mutations to the DNA of the cell. These mutations cause the cells to grow and reproduce uncontrollably. While all cells divide, cancer cells divide at a rapid pace and do not stop dividing like healthy cells do.1,3

Chemotherapy drugs work by targeting rapidly dividing cells and damaging the DNA or RNA to stop the cells from growing. Unfortunately, chemotherapy can also damage healthy cells that divide rapidly, such as hair cells and cells that line the digestive tract. When these healthy cells are damaged by chemotherapy, side effects can occur.1,3

Examples of chemotherapy for advanced breast cancer

The choice of chemotherapy drugs depends on several personal factors, including:4

  • Your treatment history
  • Your general health
  • The benefits and risks of each chemotherapy drug

There are several different types of chemotherapy. They work in different ways to stop cancer cells, including:1-4

  • Taxanes, such as Taxol® (paclitaxel), Taxotere® (docetaxel), Abraxane® (albumin-bound paclitaxel)
  • Anthracyclines, such as Adriamycin® (doxorubicin), Doxil® (pegylated liposomal doxorubicin), Ellence™ (epirubicin)
  • Platinum agents, such as Platinol® (cisplatin), Paraplatin® (carboplatin)

Other chemotherapy drugs that may be used to treat breast cancer include:1-4

  • Navelbine® (vinorelbine)
  • Xeloda® (capecitabine)
  • Gemzar® (gemcitabine)
  • Ixempra® (ixabepilone)
  • Halaven® (eribulin)
  • Neosar®, Cytoxan® (cyclophosphamide)
  • 5-FU, Adrucil® (fluorouracil)
  • Antibody-drug conjugates (containing chemotherapy)

What are the possible side effects of chemotherapy?

Side effects can vary depending on the specific chemotherapy drug you are taking. Common side effects of chemotherapy include:1-4

  • Nausea
  • Vomiting
  • Hair loss or thinning
  • Mouth sores
  • Fatigue
  • Decreased blood cell counts, which can increase the risk of infection, bleeding, and/or anemia

These are not all the possible side effects of chemotherapy. Talk to your doctor about what to expect with your specific chemotherapy treatment or if you experience any changes that concern you during treatment with chemotherapy.

Things to know about chemotherapy

Some side effects of chemotherapy can be prevented. There are also ways your doctor can help manage certain side effects, including:1-4

  • Reducing the dosage
  • Changing medicines
  • Delaying treatment regimens

Communication with your healthcare team is key. It is important to discuss any side effects you have with your doctor or nurse.

Before beginning treatment for breast cancer, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

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