When is it important to start adjuvant chemotherapy?

Within about 8 weeks. Most adjuvant chemotherapy trials stipulate that treatment begin within 8 weeks of surgery, thus this is generally the advice given.

Related Questions

What exactly is adjuvant chemotherapy?

Preventative. Adjuvant therapy, is treatment given following the primary, main or initial treatment. It is usually given after surgery where all detectable disease has been removed, but where there remains a statistical risk of relapse due to occult disease In contrast neoadjuvant therapy, is given before the main treatment to reduce the size of the tumor so as to facilitate more effective surgery. Read more...

What is the definition or description of: adjuvant chemotherapy?

Adjuvant chemo. Adjuvant chemotherapy is chemotherapy use in conjunction with another treatment modality (type). An example is most patients receive 6 cycles of chemotherapy after primary surgical debulking for ovarian cancer. This is adjuvant chemotherapy. Read more...
Given for prevention. This is chemotherapy that is given to improve the chance of cure after surgery. Read more...

If a breast cancer patient undergoes neo-adjuvant chemotherapy, how will she ever know her true nodal status?

Sentinel LN Biopsy. It is somewhat controversial when to perform sentinel lymph node (ln) biopsy in this setting: some advocate performing this prior to chemo, so as to determine an accurate stage; others believe that the status of the ln after chemo is most pertinent. In my practice, i will perform a needle-biopsy of any abnormal ln prior to chemo. If none are evident, i wait until after chemo. Read more...
She won't. I used to always ask surgeons to do a sentinel node biopsy before neoadjuvant chemotherapy for that very reason. However, newer data show the lymph node status after chemotherapy may be more important. Newer data also show that women don't always need a full axillary dissection with a few positive nodes, so i'm ok with either approach if the lymph nodes aren't enlarged to start. Read more...
"true" nodal status? With neoadj therapy, prognostic infor of staging after therapy is likely the more telling. Studies show slnbx after chemo still accurately predicts axillary nodal status. With current chemo, a 20-25% PCR is not unexpected and would include clearing previously pos nodes (found clinically or on prechemo ax u/s & fna). Delaying the slnbx can thus spare these patients additional axillary surgery. Read more...