Topic: TC vs ACT Chemo for Triple Negative?
- Posted on: Oct 24, 2009 12:04 am
Posts: 3
Here's a short history. I'm 31 and diagnosed with breast cancer. It's stage 1, grade 3, triple negative, BRCA1 positive. I had a double mastectomy. After the surgery, the report showed clear margins and clear lymph nodes (3 removed). The only cancer they saw was the 1.3cm tumor. I will be having a bone scan next week to make sure none has spread there.
Now it's time to make a chemo decision. I have talked with 3 oncologist (Dallas onc, Austin onc, my cousin who is an oncologist).
My cousin and Dallas recommend the TC every 3 weeks for 4 cycles.
Austin recommends AC+T - AC every 3 weeks for 4 cycles then T weekly for 12 weeks.
I'm torn about which to go with. I have been told ACT is more agressive, yet harder on your body and has more serious side effects. The ACT has about a 5% advantage over the TC.
I'm trying to decide if the TC is a good choice even though it won't be quite as aggressive - something to worry about since the triple negative.
I would like to know what you have found through either research or experience. What have you found or your doctors told you about the pros and cons of each? Which treatment regimen did you do and how was it?
thanks
-Rachel
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lexislove Joined: Sep 2007 Posts: 1,942 |
Oct 24, 2009 12:12 am, edited Oct 24, 2009 12:14 AM
by lexislove
lexislove wrote:
Im not Tn, but I was diagnosed at 30 with Her2+ disease...which is crazy agressive. I was perscribed ACT. I did 4 AC and 4 T every 3 weeks, 6 months of chemo. The AC has a slight increase in potential heart problems but that is mostly seen in older woman and woman who already have heart issues. If you do AC they will monitor your heart. A 5% is not a big difference, its just what you feel is good. I had no problems with AC.Being 30, I bounced back and my heart was and is fine. I know youb want to be the most agressive as possible being TN and so you should be. Your lymph nodes were clear, so that is good. I guess its up to you really. For me...5% is 5%. Im agressive ...I would do it. But thats me. You will get a lot of other opinions. But either is good really. Dx: Sep 2007, IDC 8cm, 0/6 nodes, ACT Chemo, R Mastectomy, 1 yr Herceptin, 28 Rads,Currently on Lupron, Tamox & Zometa. Exchange Sx Fall 2009, BRCA -
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LRM216 Joined: Feb 2009 Posts: 667 |
Oct 24, 2009 12:17 am, edited Oct 24, 2009 12:19 AM
by LRM216
LRM216 wrote:
Hi, I am triple negative as well and am a "young" 62. My onc gave me the choice of TC (which she said was the mildest of the three), then the AC& T (more agressive) and the TAC. Since I am a widow, work full time as a legal asst. and raise my 14 yr. old grand-daughter, she felt the AC&T was very agressive and the way to go. That is what I chose. I had an echocardiogram first, bone scan and ct. I completed all my chemo 5 weeks ago and had no major problems at all. Had it on Thursday, side effects would hit over the weekend, and returned to work on Monday. Wishing you the best through your journey. Linda edited for typo I have been put on this frightening journey against my will, but I do not have to travel it alone.
Diagnosis: 2/23/2009, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER-/PR-, HER2- |
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unklezwifeo… Joined: Aug 2009 Posts: 968 |
Oct 24, 2009 12:29 am, edited Oct 24, 2009 12:31 AM
by unklezwifeonty
unklezwifeonty wrote:
Dear Rachel, I am also a triple negative and am getting AC-->T. See my signature for my tumor info. But if I were stage I with a 1.3 cm tumor and node negative I think I'd opt for TC. Your chances are very good with any chemo, A is hard on your body and has serious side effects and it is the T that gives you the biggest insurance. The opinions of the practitioners are all over the map on whether to use A or not for HER2- BC. That said, I think they are missing an important marker or two that would help them predict with higher certainty whether A is useful. Having a cousin oncologist is valuable. Trust his/her advice and your own instinct. Ask your cousin to share the studies that compare these and other similar regimens with you. If you want to treat this very aggressively and leave no stone unturned, then use AC-->T. If you go this route, ask for Dose Dense AC, ie AC __2__ weeks 4 times before moving onto T weekly 12 times. Good luck and keep us posted. Onty
Diagnosis: 7/31/2009, IDC, 3cm, Stage IIb, Grade 3, 1/9 nodes, ER-/PR-, HER2- |
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unklezwifeo… Joined: Aug 2009 Posts: 968 |
Oct 24, 2009 12:33 am
unklezwifeonty wrote:
Dear Laura, How are you? I need a favor. I need to have DH review articles comparing TAC, Regular AC-->T and Dose Dense AC-->T and TC. Can you point me to any studies please? Love Onty
Diagnosis: 7/31/2009, IDC, 3cm, Stage IIb, Grade 3, 1/9 nodes, ER-/PR-, HER2- |
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TNBC_in_NS Joined: Aug 2009 Posts: 2 |
Oct 25, 2009 11:11 pm
TNBC_in_NS wrote:
Hi: 57 y-old worked medical job and a half (60 hrs week) just finished TC every three weeks for two tx and two tx at four weeks. Last tx last Thursday. I had a hard time with it because I was allergic to the Taxotere. Not good. See my diag. below at signature. I now have 16 rads to do, then hopefully I will be done. I might add that after my first chemo I ran an infection and had to have an abscess removed from my breast where the tumour was. That is still open and 1.1cm deep and 2 cm wide. I have had a hard time of it but I am coming out of the dark hole now. Also, was on Neupogen for 5 days after three chemos. I was out today for a hour, still very weak and SOB. TC was the only avenue for me here in NS, Avastin study was not available to me here. There were two other areas of concern under my armpits both sides, and my PET scan showed that whatever it is is shrinking so we know the meds are working so far. I will keep you all posted as I go along! Take care and keep us up-to-date. xoxo  Diagnosis: 3/30/2009, IDC, 2cm, Stage II, Grade 3, 0/3 nodes, ER-/PR-, HER2- |
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unklezwifeo… Joined: Aug 2009 Posts: 968 |
Oct 25, 2009 11:17 pm
unklezwifeonty wrote:
SOB? Onty
Diagnosis: 7/31/2009, IDC, 3cm, Stage IIb, Grade 3, 1/9 nodes, ER-/PR-, HER2- |
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TNBC_in_NS Joined: Aug 2009 Posts: 2 |
Oct 25, 2009 11:57 pm
TNBC_in_NS wrote:
Unklezwifeonty: Short of Breath.. Sorry... Diagnosis: 3/30/2009, IDC, 2cm, Stage II, Grade 3, 0/3 nodes, ER-/PR-, HER2- |
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unklezwifeo… Joined: Aug 2009 Posts: 968 |
Oct 26, 2009 12:38 am
unklezwifeonty wrote:
LOL.....Ok. Onty
Diagnosis: 7/31/2009, IDC, 3cm, Stage IIb, Grade 3, 1/9 nodes, ER-/PR-, HER2- |
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positiveabo… Joined: Feb 2009 Posts: 28 |
Oct 26, 2009 03:16 am
positiveaboutnegative wrote:
unclezwifeonty: Here's a study on TAC for TNBC: http://hormonenegative.blogspot.com/2009/03/tac-improves-disease-free-survival-for.html And another one on ACT:http://hormonenegative.blogspot.com/2007/12/reduce-recurrence-buzz-from-white-coats.html And this is an excellent overview article on TNBC treatment overall: http://www.cancernetwork.com/display/article/10165/1340727?pageNumber=2 I had AC only, not T because I was node-negative. I am not BRCA1, though. This article evaluates this issue and, in typical research-ese, says that, while AC works for node-negative, adding T is a good idea for high risk cases, such as TNBC. http://jnci.oxfordjournals.org/cgi/content/full/96/24/1801 Hope that helps. Pat hormonenegative.blogspot.com Pat
Diagnosis: 5/15/2006, IDC, 1cm, Stage I, Grade 2, 0/3 nodes, ER-/PR+, HER2- |
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unklezwifeo… Joined: Aug 2009 Posts: 968 |
Oct 26, 2009 05:46 pm
unklezwifeonty wrote:
Thanks a lot Pat. Onty
Diagnosis: 7/31/2009, IDC, 3cm, Stage IIb, Grade 3, 1/9 nodes, ER-/PR-, HER2- |
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chachingque… Joined: Oct 2009 Posts: 3 |
Oct 26, 2009 05:56 pm
chachingqueen wrote:
Thank you. I talked to my oncologist today and I'm most likely going to do the TC treatment. My dad is really worried about heart problem risks if I take A. His sister had breast cancer in the 70s and they believe what ultimately killed her was the chemo - she had heart problems at the end. He's very concerned about that happening to me. I know drugs have changed since then. |
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justpayton1… Joined: Jul 2009 Posts: 29 |
Oct 26, 2009 06:02 pm
justpayton1 wrote:
Hi 38 years old at time of dx I am also BRCA 1. I did dose dense. ACX 4 TAXOL X4 each dose was followed with a shot of neulasta. I had chemo on Thursdays and used the weekend to recover. I had swelling from the taxol and was given a water pill halfway through treatment which helped. I finished my chemo in June and seem to be okay so far... I do notice shortness of breath when walking though I am told my treatment has been aggressive but I have 2 kids to raise. I might add I am a single Mom and was able to get the kids to school, pick them up etc...Fridays were the worst days for me so we would have ' pizza night' Hugs to you Diagnosis: 2/9/2009, IDC, 6cm+, Stage IIIc, Grade 3, 2/13 nodes, ER-/PR-, HER2- |
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vbabey Joined: Sep 2009 Posts: 30 |
Oct 27, 2009 11:21 am
vbabey wrote:
justpayton1 - Pizza night is my favorite also, though now I have switched to vegetable pizza! anyway, your regime is the same as mine, except there has been mention of Gemzar added to the Taxol, which I will start in three weeks or so, has anyone ever taken that? Also, did your oncologist suggest chemo again after surgery if there was not a complete response? Thanks and have a good day all... Diagnosis: 9/16/2009, IDC, 4cm, Stage IIIa, Grade 2, ER-/PR-, HER2- |
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unklezwifeo… Joined: Aug 2009 Posts: 968 |
Oct 27, 2009 11:49 am
unklezwifeonty wrote:
Dear ChachingQueen, TC is an excellent choice. Good luck with your treatment. Onty
Diagnosis: 7/31/2009, IDC, 3cm, Stage IIb, Grade 3, 1/9 nodes, ER-/PR-, HER2- |