- Breast cancer chemotherapy
Breast cancer chemotherapy refers to the use of cytotoxic
drugs ( chemotherapy) in the treatment of breast cancer.
Chemotherapy can be given both before and after surgery.
Neoadjuvant chemotherapyis used to shrink the size of a tumor prior to surgery. Adjuvant chemotherapyis given after surgery to reduce the risk of recurrence. Palliativechemotherapy is used to control (but not cure) the cancer in settings in which the cancer has spread beyond the breast and localized lymph nodes.
Several different chemotherapy regimens may be used.cite journal | last =von Minckwitz | first =G | authorlink = | coauthors = | title =Docetaxel/anthracycline combinations for breast cancer treatment | journal =Expert Opinion on Pharmacotherapy | volume =8 | issue =4 | pages =485–495 | publisher = | date =Mar 2007 | url =http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17309343 | doi = | id = | accessdate = ] Determining the appropriate regimen depends on many factors, including the character of the tumor, lymph node status, and the age and health of the patient. In general, chemotherapy has increasing side effects as the patient's age passes 65.The following is a list of commonly used
adjuvant chemotherapyfor breast cancer:
cyclophosphamide, methotrexate, and 5- fluorouracilgiven 4-weekly for 6 cycles
*FAC (or CAF): 5-
fluorouracil, doxorubicin, cyclophosphamidegiven 3-weekly for 6 cycles
*AC (or CA): Adriamycin (
doxorubicin) and cyclophosphamidegiven 3-weekly for 4 cycles
*AC-Taxol: AC given 3-weekly for 4 cycles followed by
paclitaxelgiven either 3-weekly for 4 cycles or weekly (at a smaller dose) for 12 weeks
*TAC: Taxotere (
docetaxel), Adriamycin ( doxorubicin), and cyclophosphamidegiven 3-weekly for 6 cycles
fluorouracil, epirubicinand cyclophosphamidegiven 3-weekly for 6 cycles
*FECD: FEC given 3-weekly for 3 cycles followed by
docetaxelgiven 3-weekly for 3 cycles
*TC: Taxotere (
docetaxel) and cyclophosphamidegiven 3-weekly for 4 cycles
*Dose dense regimen: Some of the regimens above (e.g. AC followed by paclitaxel) may be given in a shorter period (i.e. every 2 weeks instead of every 3 weeks).
*In addition to chemotherapy,
trastuzumabmay also be added to the regimen depending on the tumor characteristics (i.e. HER2/neustatus) and risk of relapse. It is usually given either 3 weekly or weekly for a total duration of 1 year.
Since chemotherapy affects the production of white blood cells,
granulocyte colony-stimulating factor(G-CSF) is sometimes administered along with chemotherapy. This has been shown to reduce, though not completely prevent, the rate of infection and low white cell count. Most adjuvant breast cancer chemotherapy regimens do not routinely require growth factor support except for those associated with a high incidence of bone marrow suppression and infection. These may include chemotherapy given in the dose dense fashion i.e. 2-weekly instead of 3-weekly or TAC chemotherapy (see above).
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