Why chemo before surgery

The researchers think that treatment advances, including the development of targeted therapies such as Herceptin chemical name: trastuzumab , Tykerb chemical name: lapatinib , and Perjeta chemical name: pertuzumab that are given along with chemotherapy medicines, have made neoadjuvant chemotherapy more effective in treating breast cancer.

Although most women who have a choice prefer less invasive lumpectomy surgery, there are many factors to consider when deciding between lumpectomy and mastectomy, including:. After discussing all the information and all your treatment options, you and your doctor can make the best treatment decisions for your unique situation. For more information on the advantages and disadvantages of both lumpectomy and mastectomy, visit the Breastcancer. Lumpectomy page.

Create a profile for better recommendations. Breast implant illness BII is a term that some women and doctors use to refer to a wide range For example, if your chemotherapy treatment will cause infertility, you may wish to store sperm, fertilized eggs embryos or eggs for future use. If your chemotherapy will cause hair loss, consider a wig or a head covering, or talk to your doctor about measures that may prevent hair loss. Most people are able to continue working and doing their usual activities during chemotherapy.

Your doctor can give you an idea of how much the chemotherapy will affect your usual activities, but it's difficult to predict just how you'll feel. Prepare by asking for time off work or help at home for the first few days after treatment. If you'll be in the hospital during chemotherapy treatment, arrange to take time off work and find someone to take care of your usual responsibilities at home.

Medications or supplements you're taking, including any herbal supplements, vitamins or over-the-counter drugs, may affect the way the chemotherapy drugs work. Your doctor may suggest alternative medications or that you not take the medications or supplements for a period before or after a chemotherapy session. Your doctor or nurse will let you know what you can and can't eat or drink on the day of your chemotherapy session.

It may help to take a family member or friend with you to the treatment session for support and companionship. Chemotherapy for breast cancer is given in cycles. The cycle for chemotherapy can vary from once a week to once every three weeks. Each treatment session is followed by a period of recovery.

Typically, if you have early-stage breast cancer, you'll undergo chemotherapy treatments for three to six months, but your doctor will adjust the timing to your circumstances.

If you have advanced breast cancer, treatment may continue beyond six months. If you have early-stage breast cancer and you are also scheduled to receive radiation therapy, it usually happens after chemotherapy. There are many chemotherapy drugs available. Because each person is different, your doctor will tailor the type and dose of medications regimen — often a combination of two or three chemotherapy drugs — to your type of breast cancer and medical history.

Breast cancer chemotherapy sessions can take place at your doctor's office, at an outpatient unit in a hospital or clinic, or at home.

Chemotherapy drugs can be given in a variety of ways, including as pills you take at home. Most often they're injected into a vein IV. This can be done through:. Some people feel fine after a chemotherapy session and can return to their schedules and activities. Others may feel side effects more quickly. You may want to arrange for someone to drive you home afterward, at least for the first few sessions, until you see how you feel.

After a few sessions, you may be able to predict more accurately when you'll feel fine and when you may need to cut back on activities. Marking your calendar or keeping a journal may help you track your general response to chemotherapy sessions and plan events accordingly.

Following your treatment plan closely is the best way to get the most benefit from chemotherapy. If side effects become too bothersome, discuss them with your doctor. He or she may be able to adjust the dose or type of chemotherapy medication you're receiving or prescribe other medications to help relieve some symptoms such as nausea.

If the number of white cells in your blood drops, your doctor may stop your chemotherapy until your white cells return to a safe level. Relaxation techniques such as meditation and deep breathing may help reduce stress. And exercise has been shown to help improve sleep and lessen fatigue caused by chemotherapy. Wearing wigs, hats or turbans can make hair loss less obvious. After you complete chemotherapy treatment, your doctor will schedule follow-up visits to monitor for long-term side effects and check for cancer recurrence.

Expect appointments every few months and then less frequently the longer you remain cancer-free. If you have inflammatory breast cancer: Stage III cancers also include some inflammatory breast cancers that have not spread beyond nearby lymph nodes.

Treatment of these cancers can be slightly different from the treatment of other stage III breast cancers. You can find more details in our section about treatment for inflammatory breast cancer. Most often, these cancers are treated with neoadjuvant chemotherapy before surgery. For HER2-positive tumors, the targeted drug trastuzumab Herceptin is given as well, sometimes along with pertuzumab Perjeta.

This may shrink the tumor enough for a woman to have breast-conserving surgery BCS. Nearby lymph nodes will also need to be checked.

Often, radiation therapy is needed after surgery. If breast reconstruction is done, it is usually delayed until after radiation is complete. In some cases, additional chemo is given after surgery as well. After surgery, some women with HER2-positive cancers will be treated with trastuzumab with or without pertuzumab for up to a year.

Many women with HER2-positive cancers will be treated first with trastuzumab with or without pertuzumab followed by surgery and then more trastuzumab with or without pertuzumab for up to a year. If after neoadjuvant therapy, any residual cancer is found at the time of surgery, trastuzumab may be changed to a different drug, called ado-trastuzumab emtansine, which is given every 3 weeks for 14 doses.

For people with hormone receptor-positive cancer in the lymph nodes who have completed a year of trastuzumab, the doctor might also recommend additional treatment with an oral drug called neratinib for a year. Women with hormone receptor-positive ER-positive or PR-positive breast cancers will also get adjuvant hormone therapy which can typically be taken at the same time as trastuzumab.

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