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How is chemotherapy given?

For early stage breast cancer, combinations of drugs are often used. There are many combinations in use, and it’s not clear that any single combination is clearly the best. Clinical studies continue to compare today’s most effective treatments against something that may be better.

The most common chemo drugs used for early breast cancer include the anthracyclines (such as doxorubicin/Adriamycin and epirubicin/Ellence) and the taxanes (such as paclitaxel/Taxol and docetaxel/Taxotere). These may be used in combination with certain other drugs, like fluorouracil (5-FU), cyclophosphamide (Cytoxan), and carboplatin.

For cancers that are HER2 positive, the targeted drug trastuzumab (Herceptin) is often given with one of the taxanes. Pertuzumab (Perjeta) can also be combined with trastuzumab and docetaxel for HER2 positive cancers if the chemo is given before surgery. (For more info see Targeted therapy for breast cancer in men)

Some of the most commonly used drug combinations for early breast cancer are:

  • CAF (FAC): cyclophosphamide, doxorubicin (Adriamycin), and 5-fluorouracil
  • TAC: docetaxel (Taxotere), doxorubicin (Adriamycin), and cyclophosphamide
  • AC → T: doxorubicin (Adriamycin) and cyclophosphamide followed by paclitaxel (Taxol) or docetaxel (Taxotere). This can be given the other way around, with the T (paclitaxel or docetaxel) given first, followed by AC. Either way, carboplatin may be added to paclitaxel for cancers that are triple-negative.
  • FEC (CEF)→ T: cyclophosphamide, epirubicin, and 5-fluorouracil followed by docetaxel or paclitaxel. This can be given the other way around, with the T (paclitaxel or docetaxel) given first, followed by FEC. Either way, carboplatin may be added to paclitaxel for cancers that are triple-negative.
  • TC: docetaxel (Taxotere) and cyclophosphamide
  • TCH: docetaxel, carboplatin, and trastuzumab (Herceptin) (this is only used if the cancer is HER2 positive)

Other combinations that are less often used for early breast cancer include:

  • CMF: cyclophosphamide (Cytoxan), methotrexate, and 5-fluorouracil (Fluorouracil, 5-FU)
  • AC: doxorubicin (Adriamycin) and cyclophosphamide
  • EC: epirubicin (Ellence) and cyclophosphamide
  • A → CMF: doxorubicin (Adriamycin), followed by CMF

Many drugs can be useful to treat advanced breast cancer, such as:

  • Paclitaxel
  • Docetaxel
  • Carboplatin
  • Cisplatin
  • Gemcitabine (Gemzar)
  • Mitoxantrone
  • Vinorelbine (Navelbine)
  • Capecitabine (Xeloda)
  • Pegylated liposomal doxorubicin (Doxil)
  • Ixabepilone (Ixempra)
  • Albumin-bound paclitaxel (nab-paclitaxel or Abraxane)
  • Eribulin (Halaven).

Although drug combinations are often used to treat early breast cancer, advanced disease is more often treated with single chemo drugs. Still some combinations, such as carboplatin or cisplatin plus gemcitabine are commonly used to treat advanced breast cancer.

Some targeted therapy drugs target HER2. These may be used with chemo drugs for cancers that are HER2 positive. These drugs are discussed in more detail in the “Targeted therapy for breast cancer in men)” section.

Doctors give chemo in cycles, with each period of treatment followed by a rest period. Chemo begins on the first day of each cycle, but the schedule varies depending on the drugs used. For example, with some drugs, the chemo is given only on the first day of the cycle. With others, it is given every day for 14 days, or weekly for 2 weeks. Then, at the end of the cycle, the schedule of chemo repeats to start the next cycle. Cycles are most often 2 or 3 weeks long, but they vary according to the specific drug or combination of drugs. Some drugs are given more often. Adjuvant and neoadjuvant chemo is often given for a total of 3 to 6 months, depending on what drugs are used. Treatment is often longer for advanced breast cancer, and is based on how well it is working and what side effects you have.

 

Dose-dense chemotherapy

Possible side effects of chemotherapy


Hormone therapy for breast cancer in men

Targeted therapy for breast cancer in men

Bone-directed therapy for breast cancer in men


 

Coping and support for male breast cancer

 


Related Topics

Benign breast conditions

General breast cancer terms

Types of breast cancer in men


References

http://www.cancer.org/cancer/breastcancerinmen/detailedguide/breast-cancer-in-men-what-is-breast-cancer-in-men

http://www.breastcancer.org/symptoms/types/male_bc

http://www.cancerresearchuk.org/about-cancer/type/rare-cancers/rare-cancers-name/breast-cancer-in-men

http://www.mayoclinic.org/diseases-conditions/male-breast-cancer/basics/coping-support/con-20025972


 

Oncologists, Breast Surgeons are the specialists who deal with the breast cancer

 

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