How effective is chemotherapy before surgery for breast cancer?

Chemotherapy given before surgery is called neoadjuvant chemotherapy. It may reduce the size of a breast tumour or involved lymph nodes, which can affect the surgical options. It also gives the oncology team an opportunity to observe how the cancer responds while treatment is underway. The response seen in the breast and nodes is checked at surgery and can guide treatment after the operation. Some breast cancers respond more strongly than others because their biology differs.

Your team will review the tumour sample, hormone receptors, HER2 status, scans, general health, and medicines before recommending a regimen. Keep a record of symptoms and temperature, use the prescribed medicines as directed, and tell the team about infection symptoms or new medicines. Appointments may include blood tests and examinations to check whether treatment remains suitable. Surgery is usually planned after the intended course, with timing adjusted if recovery or treatment response needs attention.

During chemotherapy, contact your oncology service urgently for fever, chills, sudden breathlessness, chest pain, uncontrolled vomiting, severe diarrhoea, or an inability to drink. Ask in advance which number to use outside clinic hours. Do not wait for the next treatment visit when a symptom is severe or rapidly worsening.

Ask why chemotherapy is recommended before surgery, how response will be measured, what happens if the tumour does not shrink, and which treatment is expected after the operation.