What to expect from chemotherapy before surgery for breast cancer

Chemotherapy before surgery is called neoadjuvant treatment. It can shrink a breast tumour, treat cancer cells beyond the breast and show how the cancer responds to the selected medicines. The response helps the team plan surgery and may inform treatment afterward. A change in breast size or symptoms does not alone determine the final result; examination and imaging are also considered.

Before each cycle, tell the team about new symptoms, medicines, infections and pregnancy possibility. Blood tests help check whether treatment can proceed safely. Plan transport, rest and help with meals if needed. Common effects can include tiredness, nausea, appetite changes, mouth soreness, hair loss or lowered blood counts; your team can prescribe supportive medicines and explain infection precautions.

Use the urgent contact number provided by your oncology unit for fever, chills, feeling suddenly unwell, persistent vomiting, diarrhoea, mouth ulcers that prevent drinking, or redness and pain around an intravenous line or port. Seek emergency help for severe breathing difficulty, chest pain, confusion or collapse. Do not wait for the next cycle if symptoms are concerning.

Ask how many cycles are planned, how response will be checked, which symptoms need a same-day call, how fertility or contraception may be affected, and how the surgery date will be chosen.