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NCCN Guidelines for Patients


Breast Cancer - Early-Stage


, Version 1.2016


Chemotherapy and HER2 inhibitors What to expect

neuropathy is numbness or tingling of nerves in the

hands and feet. Some types of chemotherapy, such

as anthracyclines, can cause damage to the heart.

Anthracyclines include doxorubicin and epirubicin.

Pre-menopausal women may start menopause

early because of the chemotherapy drugs. Even if

menstrual periods return after chemotherapy, you

may still be unable to have babies. However, don’t

depend on chemotherapy for birth control. You may

become pregnant while on chemotherapy, which can

cause birth defects. If you had menstrual periods

before chemotherapy, use birth control but not birth

control made of hormones, such as “the pill.” Talk to

your doctors for more information.

You may have a mild flu-like response to the first dose

of trastuzumab that includes fever, chills, headache,

muscle aches, and nausea. This response is less

common with the second and third doses. Other side

effects may include damage to the heart and rarely to

the lungs.

Common side effects of pertuzumab are diarrhea,

nausea, and feeling tired and weak. Less common

side effects include skin rash, low white blood

cell counts, and mouth sores. It is not yet clear if

pertuzumab damages the heart, although similar

drugs do.

Not all the side effects of chemotherapy and HER2

inhibitors are listed here. Please ask your treatment

team for a complete list. If a side effect bothers you,

tell your treatment team. There may be ways to help

you feel better.