When the treatment of breast cancer is usually given chemotherapy using an antineoplastic (cytotoxic) drugs to fight oncology. As a rule, it is a systemic treatment, which applies throughout the body, destroying cancer cells.
Chemotherapy for breast cancer in Israeli hospitals used:
- After operation for pathological destruction of remaining segments and reduce the likelihood of disease return as adjuvant treatment. If therapy program includes radiation, chemotherapy is often given to him.
- Before surgery to reduce the size of large tumors (neoadjuvant chemotherapy).
- For the treatment of disease recurrence.
- To relieve pain or to control symptoms (palliative chemotherapy).
The decision to chemotherapy as a treatment option
When deciding on the appointment of chemotherapy for breast cancer in the clinic Assuta take into account the following factors:
- stage of the disease;
- the likelihood of relapse, including HER-2 status and hormone receptor status;
- general health, age, presence of preexisting disease (in certain cardiac pathologies are certain cytostatics contraindicated due to the risk of heart damage);
- prior chemotherapy (the use of individual drugs does not permit them to repeat);
- personal situation and preferences of women (the desire to go through therapy for a short period of time, the choice of a particular combination of drugs due to fewer side effects such as hair loss, nausea, fertility problems).
Chemotherapy for breast cancer is offered at stage 0 (in situ), because the risk of recurrence or spread of the disease to other parts of the body are very low on noninvasive tumors.
This type of treatment is usually recommended in the following cases:
- stage I or II with a high risk of disease return;
- locally advanced breast cancer, when there is a large tumor with metastasis to other parts of the breast and lymph nodes in the impossibility of surgically removed;
- metastatic or recurrent receptor-negative breast cancer, a rapidly growing or causing severe symptoms.
Chemotherapy for breast cancer can be offered as an option for the treatment of diseases in the following situations after discussing all benefits and risks:
- I or II stage disease with an average risk of recurrence;
- recurrent or metastatic endocrine tumor.
Medication dose and schemes are selected based on individual characteristics of patients.
chemotherapy drugs for breast cancer
This type of treatment in the early stages of the disease (stage I and II) is not usually given as a single formulation. Most drugs used in combination to enhance performance:
- Other preferred combinations for women with breast cancer that has spread to the lymph nodes; with locally advanced and inflammatory.
- Various drug combinations have similar efficacy.
- Patients with her2-positive breast cancer patients may be advised by biological treatment with specific combinations of cytostatics.
The most common chemotherapy regimen for breast cancer :
- AC: doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan, Procytox).
- AC - Taxol: doxorubicin and cyclophosphamide followed by paclitaxel (taxol).
- FEC - T: cyclophosphamide, epirubicin, 5-fluorouracil, followed by docetaxel.
- AC - Taxol (high-dose chemotherapy): doxorubicin and cyclophosphamide followed by paclitaxel, reducing the time between treatments. This combination is usually given with filgrastim (Neupogen) or Neulastoy (Neulasta), which are granulocyte colony stimulating factor.
- TC: docetaxel (Taxotere) and cyclophosphamide.
- TAC (or DAC): docetaxel, doxorubicin and cyclophosphamide.
- CEF: cyclophosphamide (p.o.), epirubicin (Pharmorubicin), and 5-fluorouracil
- FEC: cyclophosphamide (i.v.), epirubicin, 5-fluorouracil.
- CMF - IV: cyclophosphamide (i.v.), methotrexate and 5-fluorouracil.
- CMF - PO: cyclophosphamide (p.o.), methotrexate and 5-fluorouracil.
- Taxol - FAC: paclitaxel followed by cyclophosphamide, doxorubicin and 5-fluorouracil;
- Doxorubicin and docetaxel.
- EC - GCSF: epirubicin and cyclophosphamide, with filgrastim.
- FAC (or CAF): cyclophosphamide (p.o.), doxorubicin and 5-fluorouracil (Adrucil, 5-FU).
- Docetaxel and carboplatin (Paraplatin, Paraplatin AQ).
- Gemcitabine (Gemzar) and docetaxel.
- Gemcitabine and paclitaxel.
- Capecitabine (Xeloda) and docetaxel.
Certain chemotherapy drugs can be prescribed as monotherapy - singly for the treatment of metastatic cancer. They also recommend that patients whose disease is not responding to other treatments.
- vinorelbine (Navelbine)
- etoposide (Vesepid, VP-16) (p.o.)
- mitomycin (Mutamycin)
- Abraxane (Abraxane)
- halava (eribulin mesylate) is used in metastatic breast cancer in women who have undergone at least two regimens. Previous treatment included an anthracycline (e.g., doxorubicin or epirubicin) and taxanes (e.g., paclitaxel or docetaxel).
Colony stimulating factors can be assigned to certain chemotherapy regimens for breast cancer to help reduce these side effects:
- neutropenia - a decrease of neutrophils, which are a type of white blood cells;
- anemia - a decrease in the number of red blood cells.
Antibiotics are prescribed to reduce the likelihood of infection during treatment, especially in the high-dose therapy.