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Breast cancer health centre

Chemotherapy after surgery for early breast cancer

BMJ Group Medical Reference


This information is for people who have early breast cancer. It tells you about chemotherapy after surgery, a treatment used for early breast cancer. It is based on the best and most up-to-date research.

Does it work?

Yes. If you have early breast cancer, having chemotherapy after surgery to remove your tumour reduces the chance that your cancer will come back in the same place. It can also help you live longer.

What is it?

Most women with early breast cancer are treated with surgery to remove the cancer. Some are then given radiotherapy to their chest area to stop the cancer coming back in the place it started.

Your doctor may also suggest that you have chemotherapy. This treats your whole body and will affect both normal cells and cancer cells.

Chemotherapy can be used after breast surgery and radiotherapy to:

  • Reduce the chance of breast cancer coming back in either breast

  • Reduce the chance that breast cancer will spread somewhere else in your body

  • Control breast cancer that has already spread to other parts of your body but can't yet be detected in tests.

Some women also have chemotherapy before surgery to reduce the size of their breast tumour. This can make it easier to remove. This could make the difference between removing a breast cancer lump (breast-conserving surgery) and the whole breast ( mastectomy).

Not every woman with early breast cancer needs chemotherapy. It will probably be recommended only if:

  • There's a high risk that your cancer has spread outside of your breast and armpit area. Your cancer may be more likely to spread if you have a large cancer or the cancer cells are high-grade (this means they look fast growing and aggressive under a microscope)

  • You have cancer in lots of the nodes under your arm.

If your cancer cells are sensitive to oestrogen (they are oestrogen-receptor positive), you may be given hormone therapy, such as tamoxifen, instead of chemotherapy. Some women have both chemotherapy and tamoxifen.

Chemotherapy drugs are most effective at killing cells that divide rapidly. Cancer cells divide into new cells faster than normal cells, so chemotherapy should kill more cancer cells than normal cells.

Unfortunately, the drugs used in chemotherapy also affect other cells in the body that divide rapidly. This can cause side effects (see below).

Chemotherapy drugs can be given as tablets or as a drip (also called an IV or an intravenous infusion). You may get treatment at a clinic or hospital as an outpatient.

Just as bacteria can become resistant to the antibiotics used to fight them, cancer cells can become resistant to anti-cancer drugs. Cancer cells can change and adapt to avoid being damaged by chemotherapy drugs. Because of this, more than one drug is given at a time.

Last Updated: July 23, 2012
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.

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