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Adjuvant Chemotherapy

Adjuvant chemotherapy (i.e. given after initial surgery before there is evidence of distant spread or metastases) is based on the evidence that if chemotherapy is given immediately after surgery it will lower the risk of the cancer recurring later (go here.) The most common drugs used are noted here, and adjuvant hormonal therapy is here. Most regimens use Taxol or Adriamycin/Cytoxan (see here.) In HER-2 women, adjuvant Herceptin may be useful (go here.) (More information on hormonal therapy is noted here.)
breast_fareston_anatomy.jpg (13659 bytes) To calculate the benefits from adjuvant chemotherapy go here.
Also there are online calculators of the benefits:  Calculator (note you need to register and then click on Online Access, but it's free)

See the NCCN guidelines on adjuvant chemotherapy

Consider the following
The risk factors used to predict which patients need (or benefit) from chemotherapy may be cahnging, with new studies demonstrating that measuring the genetic mutations that are commonly found in breast cancer cells will predict more accurately the benefits and need for chemotherapy...as noted below:

 

That test was developed by Genomic Health, a company in Redwood City, Calif. The test looks at the activity levels of 21 genes in tumor samples. It categorizes the cancers as being of low, intermediate or high risk of recurrence.

To validate the test, company scientists and academic collaborators from the National Surgical Adjuvant Breast and Bowel Project used samples from 668 women. Those women had taken part in a trial in the 1980's, so it was already known whether their cancers had recurred.

Only 6.8 percent of the women rated by the test to be in the low-risk group suffered a recurrence outside the breast within 10 years, compared with 14.3 percent in the intermediate group and 30.5 percent in the high-risk group.

Those results apply only to women who are taking a hormonal drug called tamoxifen for newly diagnosed cancer that has not spread to the lymph nodes and that is stimulated by estrogen. Still, there are estimated to be at least 50,000 new cases a year that fit that category.

The data on risk, initially reported at the San Antonio Breast Cancer Symposium a year ago, showed only whether the cancer was likely to recur, not whether chemotherapy would help prevent a recurrence.

But new data presented in San Antonio yesterday, from a different trial by the same authors, showed that the patients in the high-risk group had benefited from chemotherapy while those in the lower-risk groups had not. In the high-risk group, 40 percent of patients who got only tamoxifen had a recurrence of cancer within 10 years, compared with just 12 percent who got both tamoxifen and chemotherapy. But in the low-risk group, both those who got chemotherapy and tamoxifen and those who got tamoxifen alone had a recurrence rate of roughly 5 percent.