Chemotherapy for the breast

Chemotherapy is considered one of the methods of complex therapy for malignant disease. This technique is the reception of special medicines that inhibit the growth of neoplasm and contribute to the destruction of malignant cells. Chemotherapy of the breast can be used as the main method of treatment, either before or after surgery.

[1], [2], [3], [4]

Indications for chemotherapy for the breast

As a rule, chemotherapy is administered before or immediately after surgery.

Chemotherapy should not be used for non-invasive malignant tumors (for example, ductal carcinoma in the initial stages of development, a characteristic feature of which is the accumulation of histologically altered cells without the effect of germination in nearby tissues), in the absence of metastases. In such situations it is more expedient to use hormonal treatment.

Often experts prefer to use chemotherapy in the pre-climacteric period for the diagnosis of an invasive malignant process of the breast. This is due to the fact that in this situation the disease is much more severe, and chemotherapy will help to achieve the most positive result.

Treatment with chemotherapy is shown mainly in all cases when the spread of malignant pathology to the lymphatic system is observed. And the purpose of such treatment does not depend on the size of the primary malignant focus or the functional capacity of the appendages.

Chemotherapy is often recommended to women in the pre-climacteric period with an invasive tumor, with a formation size of 1 centimeter even with unaffected lymph nodes.

Names of drugs for chemotherapy of the breast

Chemotherapy is prescribed 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 education, its aggressiveness, the presence of metastases in the lymph nodes;
• age and physiological characteristics of the patient;
• period menstrual function (reproductive, climacteric period);
• reaction of the body to the reception of chemotherapy.

Drugs for chemotherapy are divided into the following categories:

• alkylating agents - break the DNA structure of the malignant cell, which makes it impossible to further divide it. Such agents include chloromethine, melphalan, cyclophosphamide, lomustine, busulfan, fluorobenzotep, dipin, etc .;
• antimetabolites are cytostatics, which inhibit the processes necessary for the development of pathological cells. Start the reaction of necrosis of the cancer cell, which contributes to the complete gradual necrosis of the entire tumor. Preparations of this group: clofarabine, 5-fluorouracil, azacitidine, methotrexate, etc .;
• anti-cancer antibiotics - a special group of antibiotics that are used exclusively for antitumour purposes. The most common anthracycline drugs, bleomycin, actinomycin and mitomycin;
• taxanes - antitumor drugs of plant origin, belong to the alkaloids of yew tree. Among taxanes, paclitaxel and docetaxel are most commonly known.

The course of chemotherapy can be carried out using one drug, or several, combining them with each other, or appointing consistently. Most often, specialists apply complex treatment regimens using a complex of anti-cancer drugs.

Dosage of drugs for breast chemotherapy

Most often, chemotherapy is carried out by intravenous-drop method. Dosages and drug delivery schemes are individually determined, which largely depends on the specific diagnosis, oncologic stage, the general condition of the patient, and also its response to the administration of drugs.

Dosage should strictly comply with internationally accepted methods and rules.

For example, anti-cancer antibiotics are prescribed as follows:

• rubomycin - iv in 0.0008 g per 1 kg of the patient's weight for 5 days, after which a weekly break is done. If there are no complications, then repeat the course from 3 to 5 days, the administration is carried out every other day. Sometimes, according to the indications, the dosage is increased, but not more than 0.025 g per 1 kg;
• adriamycin - is administered iv in a proportion of 0.03 g / m², three consecutive days followed by a one-month break. You can use another scheme: 0.06 g / m² once a month. The drug is administered very cautiously and slowly due to the danger of developing necrosis at the site of administration;
• Bruneiomycin - administered intravenously every 2-3 days, the course of treatment usually use 0.003-0.004 g of the drug.

Antimetabolic drugs are used in such schemes:

• methotrexate - taken orally 1 to 3 tablets per day, IM or IV to 0.005 g;
• fluorouracil - used in the form of droppers from a proportion of 0.5 to 1 g per 500 ml of glucose solution 5% for 3 hours. In the form of IV 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 this scheme:

• cyclophosphamide - in the form of IV or IM injection at a dosage of 3 mg / kg 2% p-ra every day. For the entire course of treatment, usually 4-14 g of the drug is used;
• dipin - used both in / in and / m, every 24 or 48 hours. The single dosage is from 0.005 g to 0.015 g. The average treatment requires 0.2 g of the drug.

Schemes and protocols of treatment can be coordinated by the doctor also during the course of treatment, depending on the patient's state of health, the tolerability of therapy, the effectiveness of the prescribed drug.

[5], [6], [7], [8], [9], [10], [11], [12]

Chemotherapy for Breast Cancer

Some types of breast cancers can be treated with chemotherapy alone. But for the overwhelming majority of cases, this approach is unacceptable, so chemotherapy is prescribed in order to control and restrain tumor growth, while also alleviating the symptomatology. Why is chemotherapy not enough?

The fact is that often malignant cells "get used" to some medications, or do not react to them initially.

For example, imagine a situation where only 98% of malignant cells have sensitivity to the prescribed drug. This means that chemotherapy will get rid of 98% of cancers. However, the remaining 2% of surviving cells, for which the drug did not work, will continue to develop.

One of the ways to solve this issue is to use two or three different medications at the same time, capable of differently affecting the cancer cell. With this approach, the chance to completely destroy the neoplasm is higher.

There is another option that allows to destroy as much as possible all tumor cells - this is an increase in the dosage of antitumor drugs. However, such a way out of the situation also has a significant disadvantage - healthy cells suffer from high dosages, which does not have a good effect on the body.

Considering the above, it can be concluded 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 a surgical operation, it is called neoadjuvant. If treatment with chemotherapy is used after surgery, they talk about adjuvant chemotherapy.

[13], [14], [15], [16]

Adjuvant chemotherapy for breast cancer

Chemotherapy after the operation of the breast can be appointed after a while, for example, after 3-4 weeks. Time after surgery is given to the body to restore and eliminate accumulated toxic substances.

Chemopreparations will help to destroy the surviving malignant cells, thus preventing the possible re-development of the disease. Even if the surgery has been extremely successful, and the doctor has removed all suspicious tissue sites, cancer cells can be present in the blood and lymph flow, where they can only be affected by exposure to chemotherapy drugs.

Chemotherapy after removal of the breast often involves the appointment of an anthracycline (epirubicin or doxorubicin). If the doctor assumes the possibility of a re-development of a cancerous tumor, a taxotere drug is added to the treatment regimen.

Between each therapeutic course the body should be given one to three weeks for recovery. After the rest, the course is repeated, if necessary, taking into account the treatment scheme drawn up by the doctor. Such repair gaps allow to reduce side effects from chemotherapy even at significant dosages of chemotherapy drugs.

[17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27]

Red Chemotherapy for Breast Cancer

"Red" chemotherapy is the philistine name of therapy with the use of drugs-anthracyclines (epirubicin, doxorubicin). Solutions of these agents differ marked red.

If you follow this logic, then treatment with mitoxantrone should be called "blue", treatment with cyclophosphamide or fluorouracil - "yellow", and therapy with taxol - "white" chemotherapy.

The use of "red" chemotherapy is recognized as the most toxic of all chemotherapy options in the complex use of funds. This issue has not been fully studied yet, however, it is noted that each "red" drug when used alone does not have excessive toxicity, and the combined use of "red" chemotherapeutic agents can affect a large number of adverse events.

For the reasons listed above, experts recommend that chemotherapy courses alternate with "red" and, for example, "yellow" drugs, to enhance the versatile effect on cancer cells and reduce the burden on the patient's body.

Side effects of chemotherapy for the breast

The severity of side effects may depend on the sensitivity of the body to medicines. What are the side effects?

• in the loss of appetite, dyspeptic phenomena, damage to the mucosa of the digestive tract and liver;
• in the weakening of hair follicles, partial or complete baldness (hair growth is restored a few 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 administration of drugs, as well as thromboses, necrosis and swelling of veins;
• in the dysfunction of the hematopoietic system, in particular, a decrease in the number of platelets and leukocytes.

During the period of chemotherapy, the patient may feel tired, so doctors are strongly advised to rest a lot and temporarily switch to a sparing lifestyle. If you have to go to work during therapy, then you should conduct planned short breaks for recovery.

Most chemotherapeutic drugs leave the body through the urinary tract. For this reason, the kidneys experience a big load. In order to reduce the load on them, and also to remove accumulating toxic substances from the body, it is necessary to drink plenty of clean water, at least two liters.

In order to reduce the severity of side effects, you must follow several rules:

• on the procedure of chemotherapy should go, pre-a little bite. Overeating and starving are harmful;
• try not to eat heavy fatty foods;
• if nausea occurs periodically, do not go on a hunger strike, just reduce the amount of food you take;
• if the nausea does not go away, tell the doctor about it, he will prescribe you special medications that will ease the symptom.

During chemotherapy, patients can feel a change in taste and olfactory sensations. Such symptoms should disappear on their own several months after the end of therapy.

Chemotherapy for the breast can be fully effective only if the patient herself takes care of her body: eat right, live actively and not lose a positive attitude. Only in this case, rehabilitation measures will bring the desired effect, and the disease will be defeated.