Chemotherapy for breast cancer

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on May 5, 2022.

Chemotherapy uses drugs that attack and kill cancer cells or slow their division and growth. Chemotherapy drugs for breast cancer may be given in pill form or by injection or infusion and are often used in combination with other cancer treatments, such as breast cancer surgery, radiation therapy or targeted therapy for breast cancer.

When given via injection, chemotherapy treatment is delivered into a vein with a needle quickly, taking only a few minutes. If you receive an infusion, it may take up to several hours. In some instances, you may need to have a central venous catheter such as a PICC line or port installed to provide a more stable infusion site. Whether you receive an injection or infusion, chemotherapy may be administered at your doctor’s office, in a hospital or at an infusion center.

Types of chemotherapy

While not every patient with breast cancer needs chemotherapy, there are several instances when it may be warranted.

After surgery: When chemotherapy is needed after breast cancer surgery, it’s called adjuvant breast cancer chemotherapy. This type of chemotherapy is done to eliminate any remaining cancer cells that may not have been removed during breast cancer surgery and/or radiation therapy for breast cancer. It also may prevent the disease from spreading to other parts of the body and help reduce the risk of recurrence.

Before surgery: In some cases, chemotherapy may be done prior to breast cancer surgery; this is called neoadjuvant (or primary systemic) breast cancer chemotherapy. This type of chemotherapy often makes breast-conserving surgery possible by helping to reduce the size of large breast tumors and destroying cancer cells. It also helps cancer doctors determine the effect a particular regimen is having on the breast tumor.

Treatment for advanced breast cancer: In patients whose breast cancer has metastasized beyond the breast and nearby areas, chemotherapy may be the primary treatment utilized. The length of treatment is determined by your specific situation, including how well the chemotherapy is working and whether you’re able to withstand the treatment.

The type of chemotherapy drug used, and when it is used in combination with other treatments, depends on the individual patient, the type of breast cancer and its stage.

Learn more about adjuvant and neoadjuvant cancer treatments

Side effects of chemotherapy

Chemotherapy drugs attack fast-growing cells throughout the body, including cancer cells. But some normal cells in the body also grow quickly and may also be attacked by chemotherapy drugs. Those cells include:

  • Immune cells and those found in bone marrow
  • Cells found in the digestive system
  • Hair follicle cells

When chemotherapy attacks these normal, healthy cells, it may cause short-term side effects that usually go away after treatment, such as:

Long-term side effects from chemotherapy are also possible. In women who haven’t yet gone through menopause, chemotherapy may trigger:

  • Premature menopause
  • Infertility

These side effects are more likely the older you are at the start of treatment, and if they do occur, you may experience a greater risk of bone loss and/or osteoporosis as a result.

It’s important to note that getting pregnant during chemotherapy increases your risk of birth defects, so be sure to ask your doctor about appropriate birth control during treatment.

Less common long-term side effects of certain chemotherapy drugs include:

  • Heart damage (cardiomyopathy)
  • Nerve damage (neuropathy)
  • Chemo brain, in which concentration and memory are diminished, a side effect lasting for several years

And, very rarely, chemotherapy drugs may increase your risk of leukemia, usually occurring in the 10 years after treatment.

Side effects of chemotherapy vary depending on the patient, the drug(s) used and the dosage. At City of Hope, your care team will be as proactive as possible in anticipating and combating side effects so you can better tolerate your breast cancer chemotherapy treatments. Your care team may also offer a combination of supportive care services, based on your individual needs, to help you manage side effects. Nutritional therapy, naturopathic support, mind-body medicine and other services may help to reduce chemotherapy-related symptoms so you can continue to participate in the activities you enjoy.

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