Vol. 11, Issue 10, Part A (2025)

Abstract
Breast cancer remains the most common malignancy among women worldwide and heavily relies on chemotherapy across all disease stages, including early, locally advanced, and metastatic settings. Significant advancements in chemotherapy have improved survival rates; however, treatment-associated toxicities such as myelosuppression, nausea, vomiting, mucositis, peripheral neuropathy, and cardiotoxicity continue to pose significant challenges. These adverse effects significantly impact patient quality of life, treatment adherence, and all things considered, therapeutic success. Effective pharmacological management involving antiemetics, hematopoietic growth factors, neuroprotective agents, and cardioprotective drugs is essential to mitigate these toxicities and ensure uninterrupted treatment. Chemotherapy regimens that include anthracyclines, taxanes, platinum compounds, and novel targeted therapies require personalized dosing strategies based on individual pharmacokinetics and pharmacodynamics to optimize efficacy while minimizing harm. Moreover, precision medicine techniques, including genomic profiling and biomarker-guided therapies a,s well as emerging drugs and advanced drug delivery systems, show promise in reducing adverse events and overcoming drug resistance mechanisms. Ongoing research, multidisciplinary collaboration, and timely updates to clinical guidelines are critical to refining supportive care, enhancing patient quality of life, reducing toxicity, and improving treatment outcomes. This comprehensive review integrates current chemotherapy protocols, associated toxicities, molecular mechanisms of resistance, and evidence-based pharmacological management strategies. These are vital for providing optimal, holistic, and personalized breast cancer care worldwide.