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Updated: 11 Jul 2023
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Chemotherapy is a treatment which uses anticancer (cytotoxic) drugs to treat cancer. It works by interfering with the cancer cells’ ability to divide and grow. In the treatment of early breast cancer, it can be used after or before breast cancer surgery.

After surgery 

Chemotherapy is used after surgery for early breast cancer to reduce the risk of cancer returning or spreading. This is called adjuvant chemotherapy. You may have chemotherapy in combination with other treatments.

Before surgery 

Chemotherapy can be used before surgery to slow the growth of a fast-growing breast cancer or to shrink a large tumour to allow for a smaller operation (e.g. breast conserving surgery instead of mastectomy). Chemotherapy before surgery is called neoadjuvant chemotherapy. People who have inflammatory breast cancer or breast cancer that is triple negative or HER2-positive may be more likely to have chemotherapy before surgery.

Chemotherapy to treat metastatic breast cancer

Chemotherapy is often used to treat metastatic breast cancer. It can help stop or slow cancer growth.

Chemotherapy to treat early breast cancer 

Not everyone with early breast cancer will be recommended chemotherapy. Whether or not it is recommended for you will depend on your individual situation. Factors the doctors consider include the pathology of your breast cancer; the risk of the cancer coming back or spreading to other parts of the body; your general health and your preferences. Your medical oncologist will discuss whether chemotherapy is the right treatment for you and which combinations of medications are most appropriate.

Genomic (tumour profiling) tests 

Some aspects of your type of breast cancer can influence whether chemotherapy is recommended for you. Your surgeon or medical oncologist may talk to you about genomic tests. Genomic tests can help predict the likelihood of an individual cancer recurring (coming back) and can provide information to help you decide whether you may benefit from chemotherapy or some other breast cancer treatments.  

Your doctor may talk to you about genomic tests currently available, including: 

  • Oncotype DX 
  • Endopredict 
  • Prosigna 
  • Mammaprint 

These tests are not covered by Medicare and can be quite expensive – up to several thousand dollars. For further information about genomic testing, visit BCNA’s My Journey.

How does chemotherapy work? 

Chemotherapy is the use of anti-cancer drugs to destroy cancer cells. Chemotherapy is called a systemic treatment – it treats the whole body, reducing the chance of the cancer coming back in the breast or elsewhere in the body. 

Chemotherapy works by attacking fast-growing cells in your body, Cancer cells usually grow and divide faster than normal cells and are unable to repair themselves when damaged, making chemotherapy effective. There are several types of chemotherapy drugs used to treat early breast cancer.  

Most chemotherapy drugs are given by intravenous (IV) drip through a cannula (thin plastic tube) into a vein in the arm or hand. Some chemotherapy drugs are given in tablet form. Sometimes a Port or PICC may be used which means you don’t need to have a cannula inserted each time. Ports and PICCs are venous access devices used to enhance access to veins for people having chemotherapy regularly.

What are the side effects? 

As chemotherapy works by attacking fast-growing cells in the body, it also attacks some of the normal fast-growing cells in the body, including blood cells, hair follicles and cells inside the mouth, gut and reproductive organs. This causes side effects including: nausea, hair loss, fatigue and mouth and gut issues. Unlike cancer cells however, normal cells usually recover from the damage.  

Not everyone has side effects from chemotherapy and most side effects stop when chemotherapy treatment stops. Your medical oncologist or oncology nurse can give you information on ways to manage these side effects. 

If side effects are affecting your daily life, it’s important to discuss them with a member of your medical team. In some instances, your medical oncologist may be able to change your chemotherapy drug to one that has fewer side effects or reduce the dose of the chemotherapy.

Hair loss 


Mouth ulcers and taste changes 

Diarrhoea or constipation 

Menopausal symptoms 

Bone health changes 

Nail health 


'Chemo brain' 

Loss of fertility 

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