Do I Really Need Chemotherapy for Breast Cancer?
If you've recently been diagnosed with breast cancer, one of the biggest questions you may face is: Do I need chemotherapy? You're not alone in wondering this. In fact, it's a common and important concern shared by many people navigating a new cancer diagnosis.
Let’s break down the key considerations about chemotherapy for breast cancer, who really needs it, and when it might be safely avoided.
What Is Chemotherapy For?
Chemotherapy is used to reduce the risk of breast cancer recurrence, particularly in early-stage breast cancer. It can be given either before surgery (neoadjuvant) or after surgery (adjuvant) with the goal of preventing cancer from spreading to other parts of the body. Once cancer spreads (metastasizes), it becomes much more difficult to treat and, unfortunately, is no longer considered curable.
Can I Skip Chemotherapy?
Yes—not everyone needs chemotherapy. In fact, only about half of breast cancer patients in the U.S. are actually recommended to have it.
When Chemo May Not Be Necessary:
Ductal Carcinoma In Situ (DCIS):
DCIS is non-invasive, meaning the cancer cells haven’t spread beyond the milk ducts. Since DCIS doesn’t metastasize, chemotherapy is not typically used—doing so would be overtreatment.Low Genomic Risk:
Genomic tests like Oncotype DX can help determine your risk of recurrence. A low Oncotype score means chemotherapy is unlikely to help and may expose you to unnecessary side effects. In such cases, endocrine therapy and radiation are often more appropriate.Small, Hormone-Positive, HER2-Negative Tumors:
People with small tumors that are estrogen and progesterone receptor-positive and HER2-negative may not benefit significantly from chemotherapy.Serious Medical Conditions or Limited Life Expectancy:
For those with other major health issues or a life expectancy of less than 10 years, the long-term benefits of chemotherapy may not outweigh the risks. Treatment decisions should take into account overall health and quality of life.
The Truth About Chemotherapy and Risk
We understand that the idea of chemotherapy can be frightening. Some believe that “chemotherapy kills,” but this is a misunderstanding. While chemotherapy does have side effects and risks, it's not typically the cause of death—cancer is. Most people who pass away while undergoing chemotherapy do so because the cancer was aggressive or advanced, not because of the treatment itself.
Oncologists take chemotherapy decisions very seriously. They aim to strike a balance between benefit and risk, and only recommend it when the potential benefits outweigh the downsides.
Making an Informed Decision
The choice to undergo chemotherapy is deeply personal and depends on many factors: tumor type, genetic markers, overall health, and your own values. If you’re facing this decision, consider discussing all your options with your oncologist, and don’t hesitate to seek a second opinion.
A long-time practicing oncologist and professor at the University of Michigan, Jennifer has received several awards for her medical excellence and published over 150 original research articles as well as numerous editorials and book chapters. She is also a speaker and advocate, committed to improving the quality of medical care and reducing the barriers to equity among the disenfranchised.
For more information on how HuMOLYTE can support your gut health during chemotherapy, visit our product page or consult your health care provider.
This blog was reviewed by Dr. Sourabh Kharait.
This blog is for educational purposes only and is not intended as medical advice. Always consult with your healthcare provider before making any changes to your treatment plan, hydration strategies, or diet. The information provided here is based on general insights and may not apply to individual circumstances.
