Chemotherapy use is common in breast cancer even with early stage disease. It is a “systemic” therapy meaning it travels throughout the body to kill cancer cells. In contrast, surgery and radiation are “local” treatments. They only have an impact on the breast and regional lymph nodes.

Chemotherapy is recommended when your medical oncologist determines that the risk of the cancer spreading beyond the breast and lymph nodes is significant. The goal of chemotherapy is to search out any renegade cancer cells that have spread to other parts of the body and kill them. While the primary purpose of chemotherapy is to treat cancer away from the breast and lymph nodes, it does reduce your risk of local recurrence as well.

Your medical oncologist will look at several factors to determine whether or not to recommend chemotherapy to you. The first is your age. Breast cancer in younger patients tends to be a little more aggressive so we tend to recommend more aggressive therapy. If this is your situation and you still want to have children, be sure to ask your doctor about fertility preservation before you begin treatment. The remaining factors to consider are dependent on your tumor:

How big is it?

Are lymph nodes involved?

Is it ER/PR positive or negative?

Does it overexpress Her2?

What is the tumor grade?

Is it rapidly growing?

Are you pre or postmenopausal?

What is the Oncotype DX score?

All of these factors allow your medical oncologist to predict what your benefit from chemotherapy will be. Be sure to discuss the percentage by which your risk of recurrence will be reduced with chemotherapy.