CMF
Cyclophosphamide, Methotrexate, and Fluorouracil
CMF is an older breast cancer regimen still used in some settings. Less intense than AC-T but still effective for certain patients.
28 days
Cycle length
6 cycles
Typical course
5
Side effects tracked
Common Side Effects
Nausea
days 1–4
Tip: Generally more manageable than AC regimens. Anti-nausea medications usually provide good control.
Fatigue
throughout treatment
Tip: Less severe than many modern regimens. Many patients maintain near-normal activity.
Mouth sores
days 5–14 (methotrexate)
Tip: Rinse with salt water or prescribed mouthwash. Leucovorin (given after methotrexate) helps protect against severe sores.
Bladder irritation
days 1–3 (cyclophosphamide)
Tip: Drink plenty of water the day of and after cyclophosphamide. Take it in the morning so you can hydrate throughout the day.
Hair thinning
weeks 3–4 of treatment
Tip: Hair thinning (not usually complete loss) is common. Hair returns to normal after treatment.
Critical Days in the Cycle
Day 10 — Nadir
Watch for
- •Fever
- •Signs of infection
When to call:
Fever ≥100.4°F — go to the ER immediately, do not wait for a callback.
Frequently Asked Questions
Is CMF easier than other breast cancer regimens?
Generally yes — CMF has a milder side effect profile than AC or AC-T, particularly for nausea and hair loss. It is often chosen for patients who are older, have other health conditions, or when the benefit of more intensive treatment doesn't outweigh the risks.
When should I call the oncology team?
For fever ≥100.4°F during nadir — go to the ER immediately, do not wait for a callback. Call the team for: severe mouth sores making eating impossible, blood in urine (bladder irritation from cyclophosphamide), or any unexpected symptoms.
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