Things to note during breast cancer chemotherapy

In the early stage of breast cancer, the tumor grows in an infiltrative manner. Even if the tumor is small, it may cause skin adhesion if it involves the suspensory ligament of the breast. If the tumor is large, there may be symptoms such as lymphadenopathy, skin edema, nipple retraction or depression, and orange peel-like changes. In the later stage, skin satellite nodules and even ulcers may appear. At this time, remember to distinguish benign breast lesions such as inflammatory masses, breast hyperplasia and benign tumors.

During chemotherapy for breast cancer, special attention should be paid to preventing colds due to decreased resistance, keeping warm, and wearing a mask on the 2nd to 12th day of chemotherapy.

1. Preparation before chemotherapy for breast cancer

1. Patients who receive preoperative neoadjuvant chemotherapy should start chemotherapy as soon as possible after the diagnosis is confirmed by puncture biopsy; postoperative adjuvant chemotherapy should start after recovery from surgery (wound healing, generally within 1 month after surgery);

2. Before chemotherapy for breast cancer, the patient's height and weight must be measured to calculate the body surface area and determine the chemotherapy dose;

3. Before chemotherapy for breast cancer, it is generally recommended to perform large vein puncture to establish a long-term venous access to reduce drug leakage and tissue damage;

4. Patients who receive preoperative neoadjuvant chemotherapy need to undergo sentinel lymph node biopsy before chemotherapy to clarify the axillary staging;

5. The patient's blood count, heart, liver, kidney and other function tests are normal before chemotherapy, or the doctor assesses whether chemotherapy is possible.

Breast cancer chemotherapy drugs

1. Commonly used chemotherapy drugs for breast cancer are: anthracyclines (A, such as epirubicin EPI, birubicin THP, etc.), taxanes (T, paclitaxel or docetaxel), cyclophosphamide (C), fluorouracil (F), etc.;

2. Generally choose a combination plan such as AT, CAF, TAC, TC, ACT, etc., usually a 3-week plan or a 2-week plan;

3. A cycle of chemotherapy usually requires 3-4 days of infusion. Chemotherapy drugs are usually used on the first and second days, and the remaining daily infusions are drugs that reduce chemotherapy reactions and enhance efficacy. Patients should know which bottle is the chemotherapy drug and pay attention to drug reactions;

3. Side effects of chemotherapy and their management

1. Bone marrow suppression This is the most common and problematic side effect of breast cancer chemotherapy. Almost every patient will experience bone marrow suppression and a decrease in white blood cells. The general rule is that white blood cells begin to decrease on the 3rd to 5th day after chemotherapy, and reach the peak on the 7th to 10th day, and then gradually recover. If not handled properly at this time, serious complications such as infection will occur. We generally check blood routine on the 4th, 7th, and 10th days, and use white blood cell-raising drugs (granulocyte colony-stimulating factor) on the 5th to 8th day. Most patients need subcutaneous injections of white blood cell-raising drugs to get through the peak of chemotherapy. Everyone's rules are different, and you should remember your own changing rules of bone marrow suppression. If the patient has a fever or is particularly weak after chemotherapy, he should immediately check his blood picture and seek timely treatment from a doctor;

2. Allergic reaction Taxanes may cause severe allergic reactions in a few people, so pretreatment is necessary. That is, take dexamethasone tablets twice 12 hours before the infusion of paclitaxel (usually on the second day of chemotherapy). Patients must remember! Only liposomal paclitaxel does not require oral dexamethasone tablets due to drug modification;

3. Other side effects are common gastrointestinal reactions (nausea and vomiting), peripheral nerve damage, elevated transaminase, bone pain, etc., all of which are temporary. Hair loss occurs to almost everyone, which makes patients distressed, but it is also temporary. New hair will grow after half a year, and some are even better than before, so there is no need to worry.

IV. Patients’ Notes

1. During chemotherapy, pay attention to strengthening nutrition, focusing on easily absorbed, sufficient protein and vitamins, and eat more blood-producing foods such as pork liver, bone soup, etc.;

2. You can take some blood-producing health products such as donkey-hide gelatin, red dates, etc. You can also take oral Leucogen, vitamin B4, etc.;

3. During chemotherapy, due to the decrease in resistance, special attention should be paid to preventing colds, etc., and warmth should be strengthened. Wear a mask on the 2nd to 12th day of chemotherapy;

4. Large vein care is a relatively troublesome matter, especially since most patients stay at home during chemotherapy intervals. Generally, intravenous cannulae need to be flushed with heparin diluent 1-2 times a week to prevent blockage. The wound can be changed (replaced) once a week. You should ask the nurse about the care situation. Out-of-town patients can flush the cannula and change the membrane at the local community hospital.