Listen to your body. Be Aware.



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Which patients are given adjuvant chemotherapy?

Adjuvant chemotherapy is given with an intent to achieve a complete cure, and to prevent the disease from coming back. Adjuvant chemotherapy is given to patients who have undergone a 'curative' surgery for breast cancer (irrespective of whether it is a breast conserving surgery or a mastectomy). The rationale of giving adjuvant CT is that, even though the primary tumour in the breast has been operated upon, there may still be some cancer cells which may be in circulation, and chemotherapy is targeted to destroy such cells, so the chances of disease coming back becomes less. According to present guidelines, chemotherapy is given to paitents who have undergone surgery for early or locally advanced breat cancer, who meet any of the following criteria:

Which patients are given neoadjuvant chemotherapy? (NACT)

Patients who present with a locally advanced breast cancer (stage 3A, 3B), or patients who have a large (but not locally advanced) operable breast cancer and who desire a breast conserving surgery, chemotherapy is given prior to surgery with an aim to achieve a reduction in the size of the tumour and make it operable. Of course, some patients who have only a small area of skin involvement and s smaller tumour, may demand for an upfront mastectomy, and it is feasible. But studies have shown that giving a prior CT in such cases will have a survival advantage.
NACT is usually given for 4 cycles. Response is charted at every cycle by a local examination, so non responders can be identified by the 2nd cycle. Most women will be able to see some response by around 10 or 15 days after 1st chemo, and by the end of 2nd CT, the response is usually very obvious. So to sum up, the indications of neo adjuvant CT are as follows:

Which patients are given palliative chemotherapy?

The term 'palliative' CT implies chemotherapy which is given with an aim to achieve some prolongation of life, in those conditions, where we cannot achieve a 'cure'. The following are the conditions where a patient will be advised a palliative chemotherapy: