Chemotherapy regimens in breast cancer are usually decided based on several criteria. These include the stage of the disease, age of patient, tumor characteristics, hormone receptor status, Her2Neu status, cardiac condition of the patient, metastases present or not, prior exposure to certain drugs, newer markers (gene signatures, topo II expression), neuropathy, allergy, renal condition, etc.
Your question as to which drugs would work best for invasive ductal cancer, ER negative, PR negative, Her2Neu negative and 87% Ki 67 expression cannot be answered without knowing certain characteristics like age of patient, stage of tumor, setting of chemotherapy (neoadjuvant, adjuvant, metastatic) etc.
In general, studies over the last three decades have proven that anthracycline (doxorubicin, epirubicin) containing regimens are superior to non-anthracycline regimens. Also, taxanes (docetaxel, paclitaxel) add clinical benefit to patients with high risk breast cancer.
Triple negative cancers tend to be more aggressive in nature, so in the adjuvant setting, many oncologists would prefer to use a three drug combination that includes a taxane, an anthracycline, and cyclophosphomide.
All the best, and God Bless!
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