If you have breast cancer, you probably have a lot of questions about treatment options. This may include adjuvant therapy. It’s important to weigh the pros and cons to make an informed decision.

What Is Adjuvant Therapy for Breast Cancer?

Adjuvant therapy includes any treatment given with the intent of curing your cancer. This therapy occurs after primary surgery, such as a mastectomy or lumpectomy. In some cases, chemotherapy or radiation is given prior to primary therapy. Treatment prior to surgery is known as neoadjuvant therapy.

Even in early-stage tumors, it’s possible for cancer cells to travel to other parts of the body. This therapy goes after cells not eliminated by surgery. Types of therapies for breast cancer include:

  • chemotherapy
  • hormone therapy
  • ovarian suppression
  • ovarian ablation
  • ovarian removal
  • immunotherapy
  • endocrine therapy
  • radiation

Who Should Receive Adjuvant Therapy for Breast Cancer?

Having breast cancer doesn’t automatically mean you’ll receive adjuvant chemotherapy. Your doctor will most likely recommend some type of adjuvant treatment. Treatment is usually based on the risk that your cancer will grow back after surgery. Several things play a role in determining which therapy is right for you.

  • Cancer stage is a factor. A tumor larger than 5 centimeters and cancer that has spread to the lymph nodes is more likely to recur.
  • Tumor grade is a factor. Tumors that are high grade or have few or no similarities to normal breast tissue are more likely to recur.
  • Proliferative capacity, or how fast the tumor multiplies, is a factor. Tumor cells that grow slowly may have a better outcome.
  • Hormone receptor status is a factor. Tumor cells that don’t express estrogen and progesterone receptors have a high risk of recurring and can be more aggressive.
  • HER2 protein status is a factor. “HER2” is the term for human epidermal growth factor receptor 2. If your tumor produces too much HER2 protein, it’s typically considered to be more aggressive. Use of the drug trastuzumab has dramatically improved the outlook for many people.
  • Oncotype recurrence risk score is a factor.The lower the score, the less likely you are to benefit from chemotherapy. The higher the score, the more like you are to benefit.

Adjuvant Therapy Guidelines

Guidelines vary by cancer stage and the type of breast cancer. Treatments are typically similar across breast cancer stages and can be used in combination. Potential therapies may include:

  • radiation
  • chemotherapy
  • hormone therapy
  • drugs that target HER2

You may also have what is called “oncotype testing” to see if you’ll benefit from chemotherapy. If you have HER2-positive or triple-negative breast cancer, it’s likely that you’ll need to have chemotherapy.

Side Effects of Adjuvant Therapy

The side effects of adjuvant therapy vary depending on the treatment. Some people may find it challenging to cope with these side effects. They include the following:

Side Effects of Chemotherapy

Chemotherapy may cause:

  • hair loss
  • mouth sores
  • appetite changes
  • nausea
  • vomiting

Side Effects of Radiation Therapy

Radiation therapy may cause red, dry, painful skin.

Side Effects of Hormone Therapy

Hormone therapy may cause menopause symptoms such as:

  • hot flashes
  • vaginal discharge
  • joint pain
  • nausea

Depending on the type of hormonal therapy you take, you may have an increased risk of uterine cancer, blood clots, or osteoporosis. Make sure you discuss the risks and benefits of hormonal therapy with your doctor if it’s part of your treatment plan.

Speaking with Your Doctor

If you have breast cancer, talking openly and honestly with your doctor is the best way to understand your situation. Open communication is helpful as you explore your treatment options, including adjuvant therapies.

Be sure to ask your doctor about:

  • the stage and type of cancer you have
  • what treatments are appropriate
  • the pros and cons of the treatment
  • any potential side effects of the treatment

If possible, bring a family member with you for support. Keep in mind that although your doctor will make treatment recommendations, you’re ultimately in control of how to move forward.