Chemotherapy for HER2 breast cancer


I had a lumpectomy in August for stage 2 invasive ducal breast cancer. I’m HER2 + and ER+ therefore have been advised I will need chemotherapy, Herceptin and radiotherapy as well as letrozole. 
my question is how long after surgery do people start chemotherapy? I am 5 weeks PO today and have received an appointment for an echo cardiogram in 2 weeks time but no oncology appointment as yet. I’m feeling anxious that it seems a long time since surgery. A friend told me she had researched that a delay in starting treatment can affect the overall outcome. Following this I realised I actually have no idea of timescales and would be most grateful if you could advise.

  •  Hello DenB,

    Thanks for getting in touch and welcome to the online community. My name is Karen and I am one of the Cancer Information Nurse Specialists on the Macmillan Support Line.  

    It’s understandable you are feeling anxious waiting for tests and treatment. You may find this information on managing anxiety helpful.

    It’s good to hear you have an appointment for an echocardiogram soon, in preparation for your chemotherapy treatment. Unfortunately, we do not have access to NHS systems or your medical records, so we recommend that you contact your hospital doctor or breast care nurse to ask when your chemotherapy treatment will start.

    Many women are offered chemotherapy after breast cancer surgery, called adjuvant chemotherapy. Chemotherapy is started after the surgical wounds have healed and you’ve had your post-surgery review.

    The National Institute for heath and Care Excellence (NICE) recommend chemotherapy to start within 31 days of surgery. However a study showed that adjuvant chemotherapy started within 3 months of surgery can reduce risk of recurrent cancer and improve overall survival.

    If you have further questions or want to talk through, please don’t hesitate to call us on our support line.

    You may also want to have a look at our online community breast cancer forum where people with a breast cancer diagnosis can find support and share experiences, discuss cancer treatment and more.

    I hope this information is helpful. If you have any further questions, the Macmillan Support Line offers practical, clinical, financial, and emotional support.


    Best wishes


    Karen, Cancer Information Nurse Specialist 


    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email


  • Thank you for your swift reply Karen, it’s much appreciated. It was probably the only question I didn’t ask when I had my post op review, in terms of timescales for starting adjuvant chemotherapy. Your advice and information has been very helpful  and I feel reassured. I will be 7 weeks PO when I have my echocardiogram therefore will undoubtedly commence my treatment within the 3 month window. If I don’t receive an oncology appointment in the next couple of weeks I will contact my specialist breast team. Once again thank you