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Breast Cancer (Expert Forum)
DOSE DENSE REGIMEN
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
DOSE DENSE REGIMEN
by EXTEL PRES, Jun 26, 2004 12:00AM
I am a 38 year old female with a 1.7CM Infiltrative Ductal Carcinoma high Grade II(Tubile Formation:3; Nuclear Pleomorphism: 3; Mitotic Score: 1):Inavsive 75%; Intraductal Carcinoma In Situ: 25%. Margins: Negative; HER-2 negative (FISH Test) and Estrogen and Progesterone Positive. Pathology Reports were completed by Bridgeport Hospital, Dana-Farber and Weill Cornell (3 opinions, all agree). Completed a lumpectomy on 5/18/04 and Sentinel Lymph Node/Lymph Node Dissection on 6/3/04.
Two Lymph nodes were positive and removed. Left Axilla, Sentinel Node Dissection: Metastic Adenocarcinoma involving 2 out of 4 nodes; Largest positive node measures 1.6CM in diameter with focal extranodal extension. Left Axilla Dissection: No metastasis in 8 lymph nodes. According to Dana-Farber: there was no extranodal invasion and the carcinoma would be classified as AJCC (6TH Edition): T1b N1 (sn) MX.
We visted our local oncologist and received a second opinion at Dana-Farber in Boston. Both oncologists proposed Adjuvent chemotherapy using a dose dense regimen of AC followed by T. The standard being AC every two weeks for 8 weeks and then T every two weeks for 8 weeks. (16 weeks total). The local oncologist has been using a dose dense regimen of AC every two weeks for 8 weeks followed by T weekly for 8 weeks, instead of T every 2 weeks. Dana-Farber didn't have a problem with this difference as long as it doesn't go to the 3 week regimen. Dana-farber uses T weekly for patients with more advanced cancer.What do you think of the AC followed by T weekly in my case?
Doctor's Answer
by CCF-RN,MSN-rf, Jun 28, 2004 12:00AM
Dear EXTEL PRES: To date there is no research that compares dose dense (every 2 week taxol) to dose dense (weekly taxol). So, there is no easy right answer. Certainly, both are used in practice with success, although I am not aware of weekly taxol being used routinely in the dose dense arena - as dose dense therapy is pretty new as a treatment regimen. You will probably not go wrong with either option.
