Chemotherapy for Breast Cancer

Chemotherapy is the use of anticancer drugs to treat cancerous cells. Chemotherapy reaches all parts of the body, not just the cancer cells. Your oncologist will recommend a treatment plan that is individualized for you.

Specific treatment for breast cancer will be based on a variety of factors, including your age, overall health, and medical history; whether you are menstruating; type and stage of cancer; your tolerance for specific medications and procedures; expectations for the course of the disease; and your opinions and preferences.

The oncologist will also determine how long and how often you will have chemotherapy treatments. Chemotherapy can be administered intravenously (in a vein) or by pill, and is usually a combination of drugs. Treatments are often given in cycles: a treatment period, followed by a recovery period, followed by another treatment period.

Chemotherapy may be given in a variety of settings, including your home (if an oral medication), a hospital outpatient facility, a physician's office or clinic, or in a hospital.

What are the different types of chemotherapy drugs used for breast cancer treatment and their potential side effects?

As each person's individual medical profile and diagnosis is different, so is her or his reaction to treatment. Side effects may be severe, mild, or absent. Be sure to discuss with your cancer care team any possible side effects of treatment before the treatment begins. Most side effects disappear once treatment is stopped. The commonly administered drugs for breast cancer are:

Adriamycin^® (doxorubicin) - Doxorubicin is an intravenous medication. Doxorubicin is red in color, and it may turn urine red or orange for several hours following treatment. Women who receive doxorubicin sometimes experience mouth sores, but always have hair loss. This drug is most often given with cyclophosphamide with or without 5-fluorouracil (5-FU). This drug combination is referred to as "AC or FAC." Four to six cycles of treatment over 3 to 6 months are commonly administered for breast cancer.

Cytoxan®, Neosar® (cyclophosphamide) - Cyclophosphamide is an anticancer drug that can be given either intravenously or orally in tablet form. The intravenous drug is clear. Cyclophosphamide can cause irritation of the lining of the urinary bladder and often causes nausea and vomiting. This drug is most often given with doxorubicin. This drug combination is referred to as "AC." Four to six cycles of treatment over 3 to 6 months are commonly administered for breast cancer.

Folex^®, Mexate^®, Amethopterin^® (methotrexate) - Methotrexate is an anticancer drug that is usually given intravenously for women with breast cancer. The drug is yellow in color. Some women who receive methotrexate experience mouth sores following treatment. This drug is most often given with both cyclophosphamide and fluorouracil. This drug combination is referred to as "CMF." Four to six cycles of treatment over 3 to 6 months are commonly given for breast cancer.

Adrucil^®, Carac^®, Efudex^®, Fluoroplex^® (fluorouracil, 5-FU) - Fluorouracil is an anticancer drug that is given intravenously. The intravenous drug is clear. For some women, fluorouracil can cause mouth sores and diarrhea. This drug is most often given with both cyclophosphamide and methotrexate ("CMF") or with AC as FAC. Four to six cycles of treatment with CMF are usually given over 3 to 6 months for breast cancer.

Taxanes - The taxanes are a group of chemotherapy drugs that include Taxotere^® (docetaxel) and Taxol^® (paclitaxel). Taxanes are typically combined with "AC" chemotherapy in the treatment of breast cancer. Treatment with combination chemotherapy that includes a taxane improves cancer-free survival in women with stage II or stage III breast cancer. The taxanes have also been shown to benefit women with node-negative breast cancer. Treatment can be given with AC and Taxotere at the same time ("TAC") or sequentially as in AC followed by treatment with Taxol or Taxotere.