Neoadjuvant chemotherapy for breast cancer is preoperative, that is the use of chemotherapy to shrink the tumor before surgery. Neoadjuvant chemotherapy is a preferred option for many women diagnosed with breast cancer. However, it is important to note that breast cancer survival rate is the same, whether the chemotherapy is given before or after surgery.

Advantages of Neoadjuvant Chemotherapy

Neoadjuvant chemotherapy for breast cancer is  mostly carried out to reduce the tumor size and hence it makes the surgery easier. It also helps the surgery to be more successful as some healthy tissues surrounding the tumor could be removed to ensure that the entire tumor is removed. It sometimes helps to retain the breasts depending on the situation. In some cases, only the tumor is taken out and the whole breast is not removed. This is called lumpectomy or partial mastectomy. This option is not meant for everyone because ultimately it depends on the size and spread of the tumor.

Neoadjuvant chemotherapy also determines if the cancer is sensitive to a particular drug or a combination of chemotherapy drugs because your tumor shrinks if you are responding well to the treatment. Apart from neoadjuvant chemotherapy, there is no other way to predict which drug will work after the surgery because when the tumor is present it can be measured  with the help of various physical exams such as MRI, etc. There is a psychological advantage to all this, as you know the tumor is shrinking and you tend to become tolerant to future treatments. There is an option of changing the drug if the previous one does not work.

Disadvantages of Neoadjuvant Chemotherapy

It is up to you to decide how you look at the situation. The disadvantage really depends upon the factors you care about and your personal situation.

The presence or absence of cancer in the lymph nodes determines whether if the cancer has spread to other parts of the body. Neoadjuvant chemotherapy  successfully kills the your cancer cells even if they are present in the lymph nodes. Hence, you would not know whether the cancer cells were there in the lymph nodes prior to this chemotherapy. Sometimes one or two lymph nodes are removed with the help of a biopsy before neoadjuvant chemotherapy. This helps to find out if the lymph nodes are affected by the cancerous. However, as this involves general anesthesia and an operating room set up, it is done at the time of the surgery after the chemotherapy. If the lymph nodes are not affected by  without cancer cells after neoadjuvant chemotherapy treatment, then this means that the cancer was sensitive to chemotherapy. If the lymph nodes have cancerous cells or if the tumor was very large, then the doctor could include radiation therapy as part of the treatment.

Neoadjuvant chemotherapy means that you live with the tumor for a few months before it is removed surgically. Of course, this disadvantage is quite psychological. While the chemotherapy kills most of the cancer cells, some remain there and continue to grow and divide. You need to learn meditation and certain imagery techniques to get over this as it helps you focus on the tumor even during chemotherapy. However, you also live with a diseased tissue and uncertainty in case the chemotherapy is not working. There is an obvious tendency in many women to get rid of it as soon as possible.

Neoadjuvant chemotherapy for breast cancer does not increase the length of the treatment. It is generally done in four, six or eight cycles. All of these cycles could be finished before the surgery or they could be split into different durations  as per the doctor who considers the effect of chemotherapy drugs on the body.