Thanks to the advancements in medical science and improvements in breast cancer treatments including chemotherapy, it is now possible to plan the sequence of treatment in such a way that for larger tumors, one can administer chemotherapy, shrink the tumour before offering surgery. This method of using chemotherapy prior to surgery is known as neoadjuvant chemotherapy and may be of great value to select patients who wish to keep their breasts.
There are many advantages to neoadjuvant chemotherapy. Administering chemotherapy before surgery allows the oncologist to ascertain the biological behavior and to also prognosticate future course. In some tumors, as ascertained by doing specific tests on the tumor, it is preferred to offer chemotherapy first. These tumors are described as being 'Triple Negative' or 'Her-2-neu positive.' Triple negative cancer treated with chemotherapy alone and Her-2-neu positive tumors treated with chemotherapy and targeted treatment is known to respond well to neoadjuvant treatment. Surgery is performed after such treatment and if there is complete response to treatment, as ascertained by pathological analysis, it may indirectly point to a good long-term outcome. There is yet another and more common indication for using neoadjuvant chemotherapy. It is those with locally advanced breast cancer who need to be treated with neoadjuvant chemotherapy, first -to not only reduce the burden of disease locally but also systemically, meaning within the body. Neoadjuvant chemotherapy shrinks seemingly inoperable breast cancers and makes them operable post chemotherapy. This approach, however, has not shown to improve survival when compared to those who undergo surgery, first.
Preoperative Chemotherapy – Making Conservation Possible
There was a time when all large tumors and locally advanced breast cancers were treated with surgery in the form of breast removal. Effective neoadjuvant chemotherapy has changed that outlook and has In many cases, made it possible to offer breast conservation surgery to select patients with good response to chemotherapy According to a study published by Journal of the American College of Surgeons, women who have chemo before the breast cancer surgery undergo lumpectomy rather than mastectomy. Preoperative chemotherapy results in increased lumpectomy rates, thus making it a very attractive choice.
Like any other drug, the drugs used in chemotherapy can also cause side-effects. The side-effects majorly depend on the dose and type of drug used as well as the tenure of the treatment. Common side-effects of chemotherapy include diarrhea, mouth sores, vomiting, nausea, loss of hair, changes in weight, loss of appetite and fatigue.
To summarize
Yes, chemotherapy can be given and is highly advisable before surgery for locally advanced breast cancer and large sized malignant tumors. Neoadjuvant therapy does increase the rates of breast conservation surgeries in suitable cases. If you have any queries related to breast cancer and its treatment, it is advisable that you seek consultation from any of the best hospitals like Max Healthcare for a detailed knowledge about the disease, its treatment and life after it.