Breast Cancer Chemotherapy: Goals, When It Is Given, and the Procedure

Chemotherapy for breast cancer is a treatment method that works by killing cancer cells in the breast and those that have spread to other parts of the body. Doctors typically recommend chemotherapy before and/or after breast cancer surgery. This treatment may involve a single chemotherapy drug, a combination of several drugs, or a combination of chemotherapy and other treatment methods.

Although chemotherapy is effective in helping treat breast cancer, it may cause side effects during treatment and in the long term after treatment has ended. Doctors can recommend treatments to help manage side effects and explain the potential long-term risks associated with chemotherapy.

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When is chemotherapy for breast cancer given?

Not all breast cancer patients require chemotherapy. Doctors determine whether chemotherapy is necessary based on the type of cancer, tumor size, disease stage, and the patient’s overall condition. Chemotherapy may be given before surgery, after surgery, or when cancer has spread to other parts of the body.

1. Before surgery (neoadjuvant chemotherapy)

Neoadjuvant chemotherapy is given before surgery to shrink the tumor so it can be removed more easily. This approach is generally considered when:

The tumor is too large to be removed surgically right away.
Cancer cells have spread to multiple lymph nodes.
The patient has inflammatory breast cancer.

In addition to shrinking the tumor, neoadjuvant chemotherapy helps doctors assess how the cancer responds to treatment and destroy microscopic cancer cells that may have spread. For certain types of cancer, the treatment response can also help doctors estimate the patient’s prognosis.

2. After surgery (adjuvant chemotherapy)

Adjuvant chemotherapy is given after surgery to destroy cancer cells that may remain or have spread to other parts of the body. Its goals include:

Reducing the risk of cancer recurrence.
Targeting microscopic cancer cells that have not been detected through examinations.

Not all patients with early-stage breast cancer need adjuvant chemotherapy. Doctors may consider the tumor’s characteristics and the results of certain tests to determine whether the treatment is likely to benefit the patient.

3. When breast cancer has spread (metastatic breast cancer)

In metastatic breast cancer, where cancer cells have spread to other organs such as the lungs or liver, chemotherapy may be one of the main treatment options. Its goals include:

Controlling cancer growth and spread.
Helping relieve cancer-related symptoms.
Slowing disease progression.

The duration of treatment depends on how the cancer responds and how well the patient tolerates the side effects. Doctors may adjust the treatment if the cancer begins to progress again or the side effects become difficult to tolerate.

How is chemotherapy for breast cancer administered?

Breast cancer chemotherapy is generally administered through an intravenous (IV) infusion, allowing the medication to travel through the bloodstream and reach cancer cells. Depending on the type of medication and the patient’s condition, chemotherapy may also be taken orally in the form of tablets or capsules.

Chemotherapy can be administered through an IV using several methods:

Intravenous (IV) infusion: The medication is delivered through a small tube inserted into a blood vessel, usually in the hand or arm.
Central line: A special tube inserted into a large blood vessel to deliver chemotherapy medication.
PICC (peripherally inserted central catheter): A catheter inserted through a blood vessel in the arm and guided into a large blood vessel.
Chemo port: A small device implanted under the skin and connected to a large blood vessel. It allows chemotherapy medication to be administered through the port without repeatedly puncturing the blood vessels.

Chemotherapy is usually administered at a hospital or infusion center according to the schedule determined by the doctor.

How long does breast cancer chemotherapy last?

Breast cancer chemotherapy generally lasts 3–6 months, although treatment may take longer depending on the type of medication, cancer stage, and the patient’s response to treatment.

Chemotherapy is usually given in several cycles, with rest periods in between to allow the body time to recover. Medication may be administered weekly, every two weeks, or every three to four weeks, depending on the treatment protocol prescribed by the doctor.

What are the benefits of chemotherapy for breast cancer?

Chemotherapy combined with surgery can help breast cancer patients live longer than they might without chemotherapy, particularly those who are likely to benefit from this treatment. Chemotherapy can also help reduce the risk of breast cancer recurrence.

For patients with metastatic breast cancer, chemotherapy may help control cancer growth, relieve symptoms, and extend survival. However, the benefits of chemotherapy vary from patient to patient, depending on the type and stage of cancer and the response to treatment.

What are the side effects of chemotherapy for breast cancer?

Chemotherapy works by killing rapidly growing cancer cells. However, it can also affect certain healthy cells that grow quickly, leading to side effects. The type and severity of these side effects vary from patient to patient, depending on the chemotherapy drugs used and the patient’s overall condition.

Common side effects of breast cancer chemotherapy include:

Nausea and vomiting: Caused by the effects of chemotherapy drugs on the digestive system.
Hair loss: Chemotherapy can affect the cells responsible for hair growth.
Fatigue: Patients may feel weak or experience a lack of energy.
Increased risk of infection: A decrease in white blood cell counts can weaken the body’s ability to fight infections.
Mouth sores: Sores or inflammation inside the mouth.
Constipation or diarrhea: Changes in digestive system function may affect bowel movements.
Muscle and joint pain: These symptoms may occur during treatment.
Skin and nail changes: These may include dry skin, changes in skin color, or more brittle nails.

In addition to these side effects, chemotherapy may cause other complications, including long-term effects in certain circumstances. Patients should consult an oncologist to understand the potential risks, receive appropriate management, and learn which symptoms should be reported promptly during treatment.

Comprehensive breast cancer care at Mandaya Breast Cancer Center

Mandaya Royal Hospital Puri’s Breast Cancer Center provides integrated services ranging from early detection and diagnosis to treatment and breast reconstruction. The Limfedema Center (Lymphedema Center) further complements these services by helping manage lymphedema, or swelling caused by impaired lymphatic fluid flow, which may affect some breast cancer patients.

Available services include:

Breast cancer detection and diagnosis: 2D and 3D mammography, breast ultrasound, Digital PET/CT Scan, and Vacuum-Assisted Breast Biopsy (VABB) to collect breast tissue samples through a small incision.
Breast cancer surgery: Mastectomy and endoscopic lumpectomy. For selected patients, Sentinel Lymph Node Biopsy (SLNB) may be performed to assess whether cancer has spread to the lymph nodes while helping avoid unnecessary lymph node removal.
Cancer treatment: Radiotherapy, chemotherapy, immunotherapy, targeted therapy, and hormone therapy, depending on the patient’s condition.
Breast reconstruction: Aims to restore the shape of the breast after surgery to remove cancerous tissue.
Non-invasive treatment for certain benign tumors: High-Intensity Focused Ultrasound (HIFU) uses high-intensity sound waves focused on targeted tissue to treat certain benign tumors without open surgery.
Lymphedema Center: Provides lymphedema management services, including Manual Lymphatic Drainage (MLD) performed by certified physiotherapists, compression devices, and surgical procedures such as Lymphovenous Anastomosis (LVA) and lymph node transplantation.

With this range of services, patients can receive evaluations and treatment for breast cancer and related complications at one center, according to their individual medical needs.

Facilities for out-of-town and international patients at Mandaya Royal Hospital Puri

Mandaya Royal Hospital Puri provides a range of support facilities to enhance the comfort of patients traveling from other cities or countries:

VIP transportation: A pickup service from Soekarno-Hatta International Airport, train stations, or seaports to the hospital in a comfortable vehicle, accompanied by a Patient Experience Officer (PEO).
Medical ambulance pickup: Specialized transportation for patients with particular medical needs from arrival points such as airports, train stations, or seaports. The service includes medical equipment and assistance from qualified healthcare professionals.
Accommodation (Sleep Hub and apartments): Comfortable accommodation for family members accompanying patients. Sleep Hub is located on the eighth floor of the Mandaya Royal Puri building, with additional apartment options nearby.
International Patient Relations: Dedicated assistance for international patients, including medical coordination, interpretation, and administrative support. For information and assistance from International Patient Relations, please call 021 5092 8888 or email [email protected].

To make your visit to Mandaya Royal Hospital Puri easier, use the WhatsApp chat feature, book an appointment, or download the Care Dokter app from Google Play or the App Store. These options can help you arrange visits, check queue numbers, and access other information.

The information on this page is provided for educational purposes and as a general overview. It does not cover every type of medical service that each doctor may provide. To ensure that you receive care appropriate for your health condition, we recommend consulting the relevant doctor directly.

If you have any questions, suggestions, or need further information, please contact our call center at 0811-1900-2000.