Hi. Evaluation of the chemotherapy treatment is usually done after every 2-3 cycles have been given. Some of the initial imaging procedures like chest x-ray, and a liver ultrasound or CT scan, are repeated to see if any existing lesions have decreased in size or if new lesions have appeared. If the FEC is being given as adjuvant treatment (meaning that the chemotherapy is being given after curative surgery), you wouldn't immediately know if the chemotherapy is working or not, since after the surgery, there is no residual disease to measure. In adjuvant chemotherapy, you would only know if the treatment failed, because of the appearance of new lesions on the imaging studies.
High dose FEC means that the epirubicin is being given at a dose of 100 milligrams per square meter of body surface area. The usual dose of epirubicin in FEC is 60 mg/m2.
FISH (fluorescent in situ hybridization) is not a kind of treatment but a test for diagnosing a certain type of breast cancer called HER-2 positive disease. FISH involves testing the specimen taken during biopsy or surgery. No further samples need to be taken from the patient, so she does not have to endure any inconvenience at all.
If the cancer cells are HER-2 positive, the treatment usually involves giving a drug called trastuzumab (Herceptin), which is an antibody directed against the HER-2 receptor in cancer cells. Herceptin is given together with the chemotherapy by intravenous route, and is usually well tolerated, although some patients develop allergic reactions to this drug.
Most of the side effects of FEC or Trastuzumab are temporary and usually resolve within a few months after the chemotherapy sessions have been completed. The speed of recovery will depend on how strong the patient's body was before the treatment was started.
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