CEF regimen, too strong for her case?

Hi,

The patient : young woman (<35 years old) with breast cancer, Node negative, 2.5 cm tumour, ER+, HER2-. She got a mastectomy(one breast) with clear margins. Her nodes were also removed.

The oncologist recommends CEF chemo regimen for treatment. As I red, CEF is usually used for people with node positive cancer or inoperable patients.

See http://www.bccancer.bc.ca/NR/rdonlyres/9D582A99-62EF-467E-AEA3-874644D4EBF8/13131/CEFhandout4.pdf

Why not using simply FEC (as recommended for node negative)?
What is your opinion about the treatment selected?

Thank you.

[PaulMD]

Hi there.

CEF and FEC regimens use the same drugs, Cyclophosphamide, Epirubicin, and 5-Flurouracil.  In our experience, this one of the most tolerated regimens in cancer treatment, whether for early stage or advanced breast cancer.  The difference will really matter on the dose of the "E" - Epirubicin.  

For patients with node positive cancer, Epirubicin dose is computed at 100mg/m2.  For patients with node negative cancers, a lower dose of 75mg/m2 may be considered.

I suggest you clarify with your doctor regarding the Epirubicin dose to be used but I believe he will be using the 75mg/m2 dose.

Regards and God bless.