NCCN Guidelines for Patients
Breast Cancer - Early-Stage
(STAGES I AND II)
, Version 1.2016
What to expect
Before chemotherapy, your doctor may ask you to
stop taking some of your medicines, vitamins, or both.
Some of these treatments can cause chemotherapy
to not work as well or may cause health problems
while on chemotherapy. Your doctor may ask you
to eat a healthy diet and drink lots of fluids. If you
smoke, it’s important that you stop.
Chemotherapy drugs differ in the way they work, so
often more than one drug is used. A combination
regimen is the use of two or more chemotherapy
All chemotherapy drugs for stages I and II breast
cancer are liquids that are injected into a vein. Only
cyclophosphamide is made in pill form, too. The
injection may be one fast shot of drugs into a vein or
may be a slow drip called an infusion. Chemotherapy
can also be given through a needle surgically placed
in the chest or the arm. Trastuzumab and pertuzumab
are given by infusion.
Chemotherapy is given in cycles of treatment days
followed by days of rest. Giving chemotherapy in
cycles gives your body a chance to recover after
receiving chemotherapy. The cycles vary in length
depending on which drugs are used.
You will need to go to a chemotherapy center to
receive the drugs. How long your visit will be depends
on what drugs you will get. It can take a few minutes
or a few hours to finish a dose of chemotherapy.
It takes about 90 minutes to get the first dose of
trastuzumab and about 30 minutes for later doses.
For pertuzumab, it takes about 60 minutes to get the
first dose and about 30 to 60 minutes for later doses.
During chemotherapy cycles, you may be given other
drugs to help you feel your best. You may be given
drugs to fight nausea and vomiting. You may also
receive an injection under your skin the day after
chemotherapy to increase the number of white blood
cells to normal levels. Some people give themselves
the injection while others return to the clinic for it.
Blood, heart, and other tests may be given to check
The reactions to chemotherapy and HER2 inhibitors
differ among women. Some women have many side
effects. Other women have few. Some side effects
can be very serious while others can be unpleasant
but not serious.
Side effects of chemotherapy depend on the drug
type, amount taken, length of treatment, and the
person. In general, side effects are caused by the
death of fast-growing cells. These cells are found in
the hair follicle, gut, mouth, and blood. Thus, common
side effects of chemotherapy include low blood
cell counts, not feeling hungry, nausea, vomiting,
diarrhea, hair loss, and mouth sores.
Other side effects of chemotherapy may include
anxiety, fatigue, and peripheral neuropathy. Peripheral
Chemotherapy and HER2 inhibitors What to expect