Conventional or traditional chemotherapy is a time-tested method of systemic treatment. Systemic means it acts at the level of the whole organism killing cancer cells in different organs and tissues. Chemotherapy is based on the effect of chemical agents and substances on cell DNA, that said different agents act from different angles thus achieving a greater efficacy of treatment. For example, Adriamycin (also known as doxorubicin, an anti-tumor antibiotic) directly affects the cell membranes and inhibits the synthesis of nucleic acids; Paclitaxel (first derived from Pacific yew bark) affects the process of mitosis – cell division.
Depending on the time of use chemotherapy is divided into neoadjuvant (preoperative) or adjuvant (postoperative). Duration of chemotherapy, its dosage, and medications are determined based on the individual features of the tumor. Its size, lymph node involvement, biological nature of the tumor, for instance certain receptors on the surface of tumor cells, are considered.
The major goals of neoadjuvant therapy are:
- Prevention of remote spread of the tumor in case it has an aggressive phenotype;
- Assessment of the tumor’s objective sensitivity to chemotherapy;
- Preparation to breast-conserving when it is technically impossible to perform it immediately.
By the way, if complete pathological response of the tumor to neoadjuvant chemotherapy is achieved, the overall outcome of the treatment significantly improves.
The main goal of adjuvant chemotherapy is systemic control over the disease – prevention of the relapse of the disease remote both in time and in spread.
Important! All chemotherapy should be given either before or after surgery!