Chemo and Infection

I am leaning toward pre-surgical chemo raher than post-surgical chemo to increase chances of successful lumpectomy. I have hardware in my spine and have to be careful about infection. Would it be wiser to do double-dose chemo which reduces risk of infection but can only be done post-surgery? How dangerous is link between hardware in the body and infection from chemo? Are there ways to prevent infection?

[CCF-RN,MSN-JS]

Dear cupcake2, The types of chemotherapy drugs that are used to treat breast cancer not only effect the faster growing abnormal cancer cells, but can also effect faster growing normal cells in the body.  Particular to your concern, the white blood cells (WBC) that help the body fight off infection are effected by the chemotherapy drugs.  After the dose of chemotherapy is given there is a time after treatment - the nadir (about 7 days after therapy) when a person is more susceptible to infection because the WBC's have been effected and new ones have not yet developed to replace them.  The dosage and type of chemotherapy can effect the severity of the decrease in WBC's (i.e. the higher the dose the more severe the decrease in WBC's can be) and that would be the case whether given before or after surgery.  In either case care would be taken to wait upon the next dose of therapy till the WBC had recovered sufficiently, so the next dose of therapy could be given safely.  

Having "hardware" in the body can be a potential site of infection, however unless it was already infected or for some reason was being disturbed that it could be infected there would not necessarily be a reason that it should be a problem during chemotherapy.  

I am giving you a link to a website that details alot of information about chemotherapy.  You can look up how chemotherapy works in general, with discussions about side effects, nadir etc.  There is also a section that discusses infection specifically.  Also you can look up the specific drugs that are being proposed to use for your therapy.  The website is Chemocare.com and the address is www.chemocare.com.