Breast chemotherapy

One of the methods of complex therapy for malignant diseases is chemotherapy. This method involves taking special medications that inhibit the growth of tumors and promote the destruction of malignant cells. Chemotherapy of the mammary gland can be used as the main method of treatment, or before and after surgery.

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Indications for breast chemotherapy

Typically, chemotherapy is given before or immediately after surgery.

Chemotherapy should not be used for non-invasive malignant tumors (for example, ductal carcinoma in the early stages of development, the characteristic feature of which is the accumulation of histologically altered cells without the effect of growth into nearby tissues), in cases without metastases. In such situations, it is more appropriate to use hormonal therapy.

Often, specialists prefer to use chemotherapy in the pre-menopausal period when invasive malignant process of the mammary gland is diagnosed. This is explained by the fact that in this situation the disease is characterized by a much more severe course, and chemotherapy will help to achieve the most positive result.

Treatment with chemotherapy drugs is indicated mainly in all cases where there is a spread of malignant pathology to the lymphatic system. Moreover, the appointment of such treatment does not depend on the size of the primary malignant lesion or the functional capacity of the appendages.

Chemotherapy is often recommended for women in the premenopausal period with an invasive tumor, with a size of 1 centimeter, even with unaffected lymph nodes.

Names of drugs in breast chemotherapy

Chemotherapy is administered in stages to give the body breaks for rest and recovery. The use of certain chemotherapy drugs depends on many factors:

• stage and size of the formation, its aggressiveness, the presence of metastases in the lymph nodes;
• age and physiological characteristics of the patient;
• period of menstrual function (reproductive, climacteric period);
• the body's reaction to taking chemotherapy drugs.

Chemotherapy drugs are divided into the following categories:

• Alkylating agents - disrupt the DNA structure of a malignant cell, making its further division impossible. Such agents include chlormethine, melphalan, cyclophosphamide, lomustine, busulfan, fluorobenzotep, dipin, etc.;
• antimetabolites are cytostatics that inhibit processes necessary for the development of pathological cells. They trigger the reaction of cancer cell death, which contributes to the complete gradual death of the entire tumor. Drugs of this group: clofarabine, 5-fluorouracil, azacitidine, methotrexate, etc.;
• Anticancer antibiotics – a special group of antibiotics that are used exclusively for antitumor purposes. The most common are anthracycline drugs, bleomycin, actinomycin and mitomycin;
• Taxanes are antitumor drugs of plant origin, related to alkaloids of the yew tree. Among taxanes, the most well-known are paclitaxel and docetaxel.

A course of chemotherapy can be carried out using one drug or several, combining them with each other, or prescribing them sequentially. Most often, specialists use complex treatment regimens, using a complex of anti-cancer agents.

Dosage of drugs for breast chemotherapy

Most often, chemotherapy is administered intravenously. Dosages and regimens for administering the drug to the body are determined individually, which largely depends on the specific diagnosis, oncological stage, general condition of the patient, as well as his reaction to the administration of drugs.

The dosage must strictly comply with internationally accepted methods and rules.

For example, anticancer antibiotics are prescribed as follows:

• rubomycin - intravenously at 0.0008 g per 1 kg of the patient's weight for 5 days, after which a week's break is taken. If there are no complications, then a repeated course is carried out from 3 to 5 days, the administration is carried out every other day. Sometimes, according to indications, the dosage is increased, but not more than 0.025 g per 1 kg;
• adriamycin - administered intravenously at a rate of 0.03 g/m², three days in a row, followed by a break of 1 month. Another scheme can also be used: 0.06 g/m² once a month. The drug is administered very carefully and slowly due to the risk of developing necrosis at the injection site;
• bruneomycin - administered intravenously every 2-3 days, usually 0.003-0.004 g of the drug is used per course of treatment.

Antimetabolic agents are used according to the following schemes:

• methotrexate - taken orally 1-3 tablets per day, intramuscularly or intravenously at 0.005 g;
• Fluorouracil - used in the form of droppers in a proportion of 0.5 to 1 g per 500 ml of 5% glucose solution for 3 hours. In the form of intravenous injections at a dosage of 0.015 g / kg every day for 3 days, then half the dosage every 48 hours. The course can be repeated after 1-1.5 months.

Alkylating agents are prescribed according to the following scheme:

• cyclophosphamide - in the form of intravenous or intramuscular injections at a dosage of 3 mg/kg of a 2% solution every day. For the entire course of treatment, 4-14 g of the drug is usually used;
• dipin - is used both intravenously and intramuscularly, every 24 or 48 hours. A single dose is from 0.005 g to 0.015 g. The average course of treatment requires the use of 0.2 g of the drug.

Treatment regimens and protocols can also be coordinated by the physician throughout the course of treatment, depending on the patient’s well-being, tolerability of the therapy, and the effectiveness of the prescribed drug.

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Chemotherapy for Breast Cancer

Some types of breast cancer can be cured with chemotherapy alone. But for the vast majority of cases, this approach is unacceptable, so chemotherapy is prescribed to control and restrain tumor growth while alleviating symptoms. Why is chemotherapy alone not enough?

The fact is that malignant cells often “get used to” certain medications, or do not respond to them initially.

For example, imagine a situation where only 98% of malignant cells are sensitive to the prescribed drug. This means that chemotherapy will eliminate 98% of the cancer. However, the remaining 2% of surviving cells that are not affected by the drug will continue to develop.

One way to solve this problem is to use two or three different medications at the same time, each capable of affecting the cancer cell in a different way. With this approach, the chance of completely destroying the tumor is higher.

There is another option that allows you to destroy all tumor cells if possible - this is increasing the dosage of antitumor drugs. However, this solution also has a significant disadvantage - healthy cells also suffer from high dosages, which is far from the best effect on the body.

Considering the above, we can conclude that chemotherapy for breast cancer should be combined, or combined with surgical or radiation treatment. In this case, if chemotherapy is used in preparation for surgery, it is called neoadjuvant. If chemotherapy is used after surgery, it is called adjuvant chemotherapy.

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Adjuvant chemotherapy for breast cancer

Chemotherapy after breast surgery may be prescribed after some time, for example, after 3-4 weeks. Time after surgery is given to the body to recover and get rid of accumulated toxic substances.

Chemotherapy drugs will help destroy any remaining malignant cells, thereby preventing the disease from coming back. Even if the surgery was extremely successful and the doctor removed all suspicious tissue areas, cancer cells may still be present in the blood and lymph flow, where they can only be affected by chemotherapy drugs.

Chemotherapy after mastectomy often includes an anthracycline (epirubicin or doxorubicin). If the doctor suspects the cancer may recur, the drug Taxotere is added to the treatment regimen.

Between each therapeutic course, the body should be given one to three weeks to recover. After rest, the course is repeated if necessary, taking into account the treatment plan drawn up by the doctor. Such recovery intervals allow to reduce the side effects of chemotherapy even with significant doses of chemotherapy drugs.

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Red chemotherapy for breast cancer

"Red" chemotherapy is a common name for therapy using anthracycline drugs (epirubicin, doxorubicin). Solutions of these drugs are distinguished by a distinct red color.

If we follow this logic, then treatment with mitoxantrone should be called “blue”, treatment with cyclophosphamide or fluorouracil should be called “yellow”, and therapy with taxol should be called “white” chemotherapy.

The use of "red" chemotherapeutic agents is recognized as the most toxic of all chemotherapy options when used in combination. This issue has not yet been fully studied, but it has been noted that each "red" drug when used independently does not have excessive toxicity, and the combined use of "red" chemotherapeutic agents can result in a large number of side effects.

Due to the above reasons, experts recommend conducting chemotherapy courses alternately with “red” and, for example, “yellow” drugs in order to enhance the multifaceted effect on cancer cells and reduce the burden on the patient’s body.

Breast Cancer Chemotherapy Side Effects

The severity of side effects may depend on the body's sensitivity to drugs. What are the side effects:

• in loss of appetite, dyspeptic symptoms, damage to the mucous membrane of the digestive tract and liver;
• in weakening of hair follicles, partial or complete baldness (hair growth is restored several months after the end of chemotherapy);
• in hyperthermia caused by intoxication of the body;
• in the development of vascular inflammatory diseases at the site of drug administration, as well as thrombosis, necrosis and venous edema;
• in dysfunction of the hematopoietic system, in particular, a decrease in the number of platelets and leukocytes.

During chemotherapy, the patient may feel tired, so doctors strongly recommend getting plenty of rest and temporarily switching to a gentle lifestyle. If you have to go to work during therapy, you should take scheduled short breaks to restore your strength.

Most chemotherapeutic agents leave the body through the urinary tract. For this reason, the kidneys experience a lot of stress. In order to reduce the load on them, as well as remove the accumulated toxic substances from the body, you should drink a lot of clean water, at least two liters.

In order to reduce the severity of side effects, it is necessary to follow several rules:

• You should go to chemotherapy after having a small snack. Overeating and starving yourself are harmful;
• try not to eat heavy, fatty foods;
• If nausea occurs periodically, do not start a fast, just reduce the amount of food you eat;
• If nausea does not go away, tell your doctor about it, he will prescribe you special medications that will relieve the symptom.

During chemotherapy, patients may experience changes in taste and smell. These symptoms should resolve on their own within a few months after the end of therapy.

Breast chemotherapy can be fully effective only if the patient herself takes good care of her body: eats right, lives actively and does not lose her positive attitude. Only in this case will rehabilitation measures bring the desired effect, and the disease will be defeated.