Chemotherapy choices for Breast Cancer

I am a 46-year-old pre-menopausal woman with Stage II, high grade invasive mammary carcinoma. Have had lumpectomy(Dec), mastectomy with sentinel node biopsy(Jan)and complete axillary dissection(Feb). SN were positive and 12 of 12 axillary nodes were neg. Am also PR+/ER+/Her2+. Oncologist has offered two options for chemo: AC and CEF. Other than the difference in length of treatment (4 mos. vs. 6 mos.), are there any other differences between these two treatments, such as risk factors, side effects,etc? Will one be more effective than the other or provide greater survival rate or reduce rate of recurrence?Should I also be considering taxanes and what would that do for me? Thank you for your input.

[CCF-RN,MSN-rf]

Dear chirok17: The AC and CEF regimens have never been directly compared but each has been compared to the old standard "CMF" regimen in well designed clinical trials. In brief, the three-month AC regimen was equal in effectiveness to the six-month CMF regimen. CEF, also a 6-month regimen, was somewhat more effective than CMF but was also associated with more toxicity. The other way to improve upon the efficacy of standard 4 cycles of AC chemotherapy is with the addition of 4 cycles of paclitaxel chemotherapy.  The sequential use of AC followed by paclitaxel may be even more effective if given on an every 2-week scedule (which takes 4 months) rather than an every 3-week schedule (which takes 6 months). As you can see, there are a variety of regimens which can be used and you may benefit from further discussion with a medical oncologist with expertise in breast cancer. You may also wish to discuss the value of including the drug trastuzumab (Herceptin) and the role of adjuvant hormonal therapy given the presence of Her2neu overexpression and hormone receptor positivity.