What is neoadjuvant chemotherapy (preoperative chemotherapy)?

Neoadjuvant chemotherapy is a type of cancer treatment where chemotherapy drugs are administered before surgical extraction of the tumor. Your doctor may recommend neoadjuvant chemotherapy to shrink the breast cancer tumor to give him or her more surgical options for your care. Shrinking the malignant tumor can help the surgeon distinguish between healthy or cancerous tissue.

In many patients, neoadjuvant chemotherapy can improve the outcome for the patient and improve postoperative recovery.

Who is a candidate for neoadjuvant chemotherapy (preoperative chemotherapy)?

Candidates for neoadjuvant chemotherapy include patients who:

  • Have Her2-neu receptor positive breast cancer
  • Have triple-negative breast cancer
  • Have a large cancer tumor that needs to be reduced in size, so the patient can have a lumpectomy instead of a mastectomy
  • Need genetic testing to determine if she has the breast cancer gene
  • Are clinical trial participants who are taking newer chemotherapy drugs for breast cancer treatment

What are the risks and side effects associated with neoadjuvant chemotherapy?

Delaying surgery to remove the cancerous tumor can allow the tumor to spread throughout the body, making it harder to treat.

Other side effects associated with neoadjuvant chemotherapy vary depending on how your body responds to treatment. Most side effects are short-term and subside when treatment is over.

Side effects may include:

  • Hair loss
  • Extreme fatigue
  • Weight loss or loss of appetite
  • Vomiting and nausea
  • Sores in the mouth
  • Neuropathy (nerve damage)
  • Increased risk of infection
  • Decreased cognitive function
  • Constipation or diarrhea

Chemotherapy can cause longer term side effects such as:

  • Infertility
  • Osteoporosis
  • Leukemia
  • Heart disease

What to expect during neoadjuvant chemotherapy?

Neoadjuvant chemotherapy is performed in cycles. You will be administered a round of chemotherapy treatments followed by a resting cycle. Chemotherapy can be given via IV or orally. The number of cycles you will need varies from patient to patient. Healthy patients who have responded well to the chemotherapy treatments may be able to have surgery within weeks after the last cycle of neoadjuvant chemotherapy.

Recovery from neoadjuvant chemotherapy

Chemotherapy side effects can last up to six months after your final treatment. Your doctor will closely monitor how you are recovering from the chemotherapy over the recovery period.

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