When is chemotherapy before surgery recommended for breast cancer?

This approach is called neoadjuvant chemotherapy. Medicines are given before an operation to treat cancer cells throughout the body and to see how the tumour responds while treatment is underway. A response can help the surgical team plan the operation. The decision depends on tumour size and location, lymph-node findings, biopsy features such as hormone-receptor and HER2 status, your general health, and whether another medicine is needed alongside chemotherapy. Some breast cancers are better treated with surgery first or with a different first treatment.

Your team may arrange breast imaging, a biopsy review, blood tests, and sometimes assessment of the lymph nodes before starting. Ask how many treatment cycles are planned, how response will be checked, and when surgery would follow. Tell the team about medicines, allergies, pregnancy plans, heart conditions, and previous treatment. During therapy, report fever, new breathlessness, uncontrolled vomiting, or signs of infection promptly. Read more about [Chemotherapy Before Surgery](/treatments/systemic-therapy/neoadjuvant-chemotherapy/) and [Breast Cancer](/conditions/breast-cancer/).

Contact your oncology team urgently for a fever or chills, difficulty breathing, chest pain, confusion, severe weakness, persistent diarrhoea or vomiting, or bleeding that does not settle. Seek emergency help for severe breathing difficulty, collapse, or sudden swelling of the face or throat. These symptoms can have causes unrelated to cancer, but treatment can make some infections and complications need prompt assessment.

Which tumour features make treatment before surgery suitable for me? How will you measure the response? Could treatment change the type of breast operation I need? What side effects should I report the same day? What support is available for nausea, fatigue, work, and daily activities?