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Chemotherapy drug treatments are also used to reach cancer cells wherever they are in the body, even if they are not yet detectable. The decision regarding chemotherapy is taken on a case-by-case basis by a team of chemotherapists, surgeons, radiation oncologists, radiologists and pathologists during a Multidisciplinary Team Meeting or Staff Meeting.
Chemotherapy is usually administered by infusion, sometimes orally in tablet form.
- In most cases, chemotherapy begins after surgery (adjuvant chemotherapy). It is indicated in the case of some invasive cancers, when statistics show that chemotherapy significantly reduces the risk of local recurrence or metastasis. These risks are calculated based on the 'identity card' of each cancer.
- Chemotherapy is sometimes proposed before surgery (neoadjuvant chemotherapy). The purpose of this might be to reduce the size of a tumour to enable breast-conserving treatment.
Chemotherapy might also be given before a mastectomy, in the case of an inflammatory tumour.
- Chemotherapy is also the preferred treatment for metastases.
Doctors can sometimes use a genetic analysis of the tumour (genome analysis) to clarify the need for chemotherapy. For French residents, this test is not covered by health insurance because its reliability is under discussion.