Chemotherapy Treatment

After your mastectomy or lumpectomy, your oncologist may advise you to have what is called adjuvant therapy involving radiation therapy, chemotherapy or hormone therapy. The type of therapy recommended will depend on your particular circumstances and may affect the decisions you make about reconstructive breast surgery at the time of your initial operation.

If you are to undergo radiation therapy for example, then it is likely that you would be recommended to have your breast reconstruction at a later date as radiation can affect the result of reconstructive surgery. Chemotherapy is not thought to have this detrimental effect on the outcome of later reconstructive breast surgery.

How Chemotherapy Works

You may be advised to undergo chemotherapy prior to surgery in order to shrink your tumour (known as neoadjuvant therapy) and allow more surgical options. By shrinking your tumour you are more likely to be able to have breast conservation surgery, also known as breast-sparing surgery. Chemotherapy uses drugs to kill cancer cells or to stop them dividing and a tumour becoming larger. Usually a combination of drugs is used as this is more effective than a single drug given alone. There are likely to be side-effects from your chemotherapy, and discussing these with your oncologist prior to treatment can allow you to be better prepared for any adverse reactions you experience from the drugs.

How is Chemotherapy Administered?

You may be offered chemotherapy to reduce the risks of your breast cancer coming back. This is given every two or three weeks for six to eight times (a cycle) via an injection into the vein or a drip. As the drugs can be toxic to the veins, we usually suggest a semi permanent access point called a portacath.

This is placed by a consultant vascular surgeon under a general anaesthetic. This will enable blood tests and treatments to be given without the discomfort of repeated needle tests. It can be removed when your treatment is completed.

Nuffield Hospital Brighton has a newly refurbished chemotherapy unit, offering eight en suite single rooms, and an open plan ambulatory suite. Nursing staff are all recognised qualifications in the administration of chemotherapy.

Can I Continue Working Whilst Undergoing Chemotherapy?

Most women choose to continue working whilst having chemotherapy treatment, and you may find that this works well for you too. You may be able to schedule your treatments around your working day, with availability in the evening or at weekends. If you experience side-effects then this may make things more difficulty and you may feel that taking a break from work will make things easier to manage. Side-effects may also lead to a more rigid treatment schedule which may be hard to fit around your working timetable.

How Will I Know the Chemotherapy is Working?

You may, like a number of other women, experience few, or no, side-effects with chemotherapy. This does not mean that it is not working. If you have chemotherapy prior to your mastectomy then your oncologist will be able to assess the extent to which your tumour has shrunk, or been halted in its growth. If you have chemotherapy as an adjuvant treatment after your mastectomy or lumpectomy then it is harder to assess its success as there are no tumours left to analyse. Research supports the use of chemotherapy after breast surgery as an effective preventative technique for reducing the risk of recurrence of your cancer. If your cancer has metastasised then blood tests, scans, and/or X-Rays will be used by your doctor to assess your progress during chemotherapy treatment.

Does Breast Reconstruction Delay Chemotherapy?

Breast reconstruction should not delay your chemotherapy. Your oncologist will usually wait until you are fully healed from your mastectomy to commence chemotherapy treatment, and any complications, such as prolonged wound healing or infection, may mean that your chemotherapy has to wait a little longer. If you have opted for breast reconstruction surgery that involves tissue expansion at the time of your chemotherapy, in order to create a pocket for a permanent implant, then your surgeon is likely to take a sample of blood in order to assess your ability to fight any bacteria that may become introduced to the skin during this process.

What if I Delay Reconstructive Breast Surgery?

Your oncologist will usually recommend that you wait at least a month after chemotherapy is complete before undergoing breast reconstruction. This is one of the reasons why it may be a preferred option for you to have a mastectomy, or lumpectomy, and reconstructive surgery during the same procedure so as to prevent additional surgery and a delay that may affect your self-confidence.