Chemotherapy for breast cancer in women

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The aim of chemotherapy is to do the maximum damage to cancer cells while causing the minimum damage to healthy tissue. Women with breast cancer may have chemotherapy:

  • Before surgery to shrink the cancer. This is known as neo-adjuvant (or primary) chemotherapy. If it shrinks the cancer successfully, only part of the breast may be removed, avoiding the need for a mastectomy.
  • After surgery if doctors think there is a risk of the cancer coming back. This is known as adjuvant chemotherapy. Decisions about adjuvant chemotherapy are made after the tissue removed during surgery is tested (pathology report).
  • As treatment for breast cancer that has spread or come back.

Chemotherapy drugs are usually given as an outpatient, either by injection into a vein (intravenously) or as tablets. Chemotherapy into the vein is given as a session of treatment, usually over a few hours. This is followed by a rest period of a few weeks, which allows the body to recover from any side effects of the treatment. A complete course of chemotherapy is likely to take 4–6 months.

There are many different chemotherapy drugs used to treat breast cancer, and they’re often used in combinations (chemotherapy regimens) usually a combination of about 3 chemotherapy drugs (see Cancer Research UK for a list of chemotherapy drugs and the most common combinations for breast cancer).

Here women we interviewed discuss their experiences of chemotherapy and its side effects.

Having heard or read about chemotherapy and its side effects, many women were anxious or concerned about having it. Several described the procedure, and many commented on the comfortable clinic environment and supportive staff. One woman who had inflammatory breast cancer was given constant chemotherapy for several weeks and described her experience.

Describes her experience of having constant chemotherapy for several weeks.

Age at interview 56

Gender Female

Age at diagnosis 53

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Comments on the supportive hospital environment.

Age at interview 41

Gender Female

Age at diagnosis 39

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Describes her experience of having constant chemotherapy for several weeks.

Age at interview 52

Gender Female

Age at diagnosis 48

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Tess was 33 when she was diagnosed, and pregnant. She had chemotherapy during her pregnancy and very few side effects.

The doctor assured Tess that it was safe for her to have chemotherapy while she was pregnant. She…

Age at interview 38

Gender Female

Age at diagnosis 33

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Chemotherapy affects different people in different ways. A few women had no or minimal side effects and some of them continued working through the treatment.

Comments that she coped very well with chemotherapy.

Age at interview 57

Gender Female

Age at diagnosis 54

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Janet was a broadcast journalist and carried on working during chemotherapy. She featured on a…

Gender Female

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For many women, however, chemotherapy was a difficult experience because of the side effects, and most were unable to work at this time. Common side effects included:

  • tiredness
  • weakness
  • nausea
  • vomiting
  • diarrhoea
  • hair loss
  • weight change
  • altered sense of taste.

Women often temporarily experienced several of these side effects. Many said they felt low, tired, a lack of energy or weakness and several noted that, once they knew what to expect, accepting the treatment became much easier.

Describes her feelings of tiredness during chemotherapy.

Age at interview 27

Gender Female

Age at diagnosis 24

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Ingrid had severe diarrhoea and felt exhausted. Her experience was complicated by other health…

Age at interview 61

Gender Female

Age at diagnosis 58

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Nausea and vomiting were also common side effects for some women. Others discussed their experiences of weight gain or loss, and altered sense of taste.

Describes her nausea during chemotherapy.

Age at interview 41

Gender Female

Age at diagnosis 37

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Describes her weight gain and tiredness during chemotherapy.

Age at interview 61

Gender Female

Age at diagnosis 59

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She describes changes in her preferences for taste and smells during chemotherapy (cisplatin).

Age at interview 19

Gender Female

Age at diagnosis 18

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Some chemotherapies cause hair loss. A few women described the cold cap procedure that aims to reduce hair loss, though several also noted its failure in their case.

Comments on her hair loss resulting from chemotherapy.

Age at interview 59

Gender Female

Age at diagnosis 58

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Comments on the cold cap and losing her hair.

Age at interview 61

Gender Female

Age at diagnosis 59

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Several women who lost their hair decided to have their heads shaved. Others described wearing wigs and scarves at this time. Pricking pains, buzzing or burning sensations to the head were also reported by some women. Some women said they felt restless.

Describes shaving her head and comments that having no hair can look beautiful.

Age at interview 34

Gender Female

Age at diagnosis 30

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Janet had several wigs, one of which was made of real hair. She had it cut and styled and felt…

Gender Female

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Describes her feelings of restlessness because of chemotherapy.

Age at interview 63

Gender Female

Age at diagnosis 58

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One woman described having oral thrush as a result of chemotherapy. Another woman said she had cystitis, as an unusual side effect of chemotherapy.

Menopausal symptoms were reported by some women and one woman, having experienced several severe side effects, refused further chemotherapy. Doctors prescribe chemotherapy if they believe that the additional chance of cure outweighs the side effects. The patient has a chance of weighing pros and cons, and many women stressed that the benefits of treatment outweigh the temporary side effects. Most women also felt encouraged by the support they received at this time from family, friends, hospital staff and other patients (see Sources of support).

Describes her severe side effects and why she chose not to have more chemotherapy.

Age at interview 57

Gender Female

Age at diagnosis 55

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Janet was told she would need to have a mastectomy, chemotherapy and radiotherapy. She asked her doctor whether she could have chemotherapy before surgery rather than after it, in the hope that it might shrink the tumour and rule out the need for a mastectomy. Her doctor agreed that, in her case, having chemotherapy first would be possible.

Janet was delighted that her tumour shrunk after chemotherapy and that she did not need a…

Gender Female

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A few women said they’d experienced complications during or after chemotherapy. Ingrid had a serious complication during chemotherapy and went to Accident and Emergency, where she was treated for a bi-lateral pulmonary embolism (blood clot in the lungs). Gillian had a viral infection shortly after the end of treatment and went into hospital for a week.

Ingrid had a very serious complication during chemotherapy. She wanted to maintain her dignity…

Age at interview 61

Gender Female

Age at diagnosis 58

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Shortly after the end chemotherapy Gillian caught a viral infection and went back into hospital…

Age at interview 55

Gender Female

Age at diagnosis 51

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Healthtalk has a whole section on breast cancer in men, for more information see Chemotherapy for breast cancer in men.

Radiotherapy for breast cancer in women

Radiotherapy is given, where appropriate, to reduce the risk of a recurrence of breast cancer. It is a standard part of treatment after breast-conserving surgery...