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Breast Cancer (Expert Forum)
2ND OPINION
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.
2ND OPINION
by WORRIED DAUGHTER, Nov 18, 2001 12:00AM
My 57 year old mom has had a lumpectomy and sentinal node biopsy. The node was positive and the lump was about 1/2". the margins have been cleared and she is es/pr positive and her2 negative. She went thru menopause in her early 40's and was immedietley put on replacement therapy. Since her diagnosis she has stopped. The first oncologist suggested 4 cycles of AC, 4 cycles of Taxol, 6 weeks radiation and 5 years tamoxifin (tamoxifen). 2nd doctor said 4 cycles AC and definitely do not take the Taxol, he said 6 weeks radiation and also tamoxifin (tamoxifen). But now we are going to a third doctor and hope that this decision does not have to be made by US, or her. I know the NIA study that was published in Nov of 2000 states there is no benefit to using Taxol after AC in a casr like my mom's. Is it still in clinical trial? I know it has a bad rep, but are 4 AC treatments enough? Are there any other published studies that you can refer that argue the benefit of Taxol after AC? We are really confused and want to be sure we are fully educated and understandin everything in it's entirety. thank you Very much.
Doctor's Answer
by CCF-RN,MSN-rf, Nov 19, 2001 12:00AM
Dear WORRIED: The first question is did your mother have a lymph node dissection (removal of a larger sample of lymph nodes) to determine if there are other positive nodes? This information would help determine whether she is eligible to participate in a clinical trial. The jury is still out in terms of the addition of taxol. A preliminary analysis is that there may be a small benefit to the addition of taxol in estrogen receptor negative patients. However, it is too soon to tell how this will play out - whether there will be any benefit to other subgroups or to the group as a whole. This is a controversial topic - one for which you will likely get multiple opinions. Four cycles of AC is standard treatment. You must remember, more is not necessarily better when dealing with chemotherapy. Benefits should outweigh toxicities.
