Types of Chemotherapy

Written by : Dr.M.D.Mazumdar, MD

Chemotherapy is the process by which cancer-killing drugs are either injected into the body or are given as oral pills. Chemotherapy usually follows surgery for breast cancer. Sometimes it may be given together with surgery as well as radiotherapy. Hormone therapy may be used as a follow-up treatment.

Chemotherapy helps destroy any undetected cancer cells which may remain after surgery. This decreases the risks of the cancer recurring.

Drugs used in chemotherapy for breast cancer are similar to other cancers but the drug regimes for giving them may vary. The doctor decides the treatment plan for each individual. He/she will also determine how long and how often chemotherapy treatments must continue.

Chemotherapy usually is not recommended for non-invasive, in situ cancers such as DCIS and LCIS because they have very little risk of spreading to other parts of the body. chemotherapy is given in cycles - which means that the drugs are given for 4-6 weeks and then a rest period of a few weeks is allowed. Then the treatment is repeated.

The types of drugs used in chemotherapy as well as the drug regime is based on:

  • Overall health of the patient.
  • Age
  • The type, size and stage of the tumor.
  • Number of lymph nodes involved and degree of involvement
  • Whether the tumor has metastasized or whether there are high risks of the tumor metastasizing.
  • Hormone receptors in the breast.
  • Whether the patient is still menstruating. More aggressive treatment is necessary in women who have not attained the age of menopause.
  • Side effects of and an individual's tolerance of specific drugs.

Types of Chemotherapy: There are three types of chemotherapy:

Neoadjuvent Chemotherapy: This is a type of chemotherapy which is given before surgery to shrink the tumors. This can help make the operation easier for both the surgeon as well as the patient and allows the surgeon to remove the tumor completely. It also allows the surgeon to do a lumpectomy and preserve the breast, rather than go for a mastectomy and remove the breast completely.

This type of chemotherapy decreases the risks of the recurrence of the cancerous cells. It is the treatment of choice in:

  • Inflammatory breast cancer.

  • HER2-positive breast cancer.

  • Triple-negative breast cancers

  • High-grade tumors

  • Cancers that have spread to the lymph nodes

  • Larger tumors

    Adjuvent Chemotherapy: In this case, chemotherapy is given after the surgery to treat any cancer cells which may still be present in the body - in the chest wall or in the lymph nodes or that which has spread elsewhere in the body. It is designed to prevent recurrence of the disease, particularly distant recurrence.


    Adjuvent Chemotherapy is recommended if the breast cancer is invasive, it it has unfavorable prognostic factors, if it is quite large, or if it has spread to nearby lymph nodes. It may also be recommended if the patient is relatively young at the time of diagnosis.

    Palliative Chemotherapy: It is used to control the cancer in women in whom the cancer has spread beyond the breast and localized lymph nodes. It is not curative and does not clear up the cnacer. But it helps to control various symptoms like pain etc, and makes the remaining years of the life of the patient somewhat easier. It may be used in combination with targeted therapy or immunotherapy.