chemo regime

[Debbie1987]

I am stage 1, tumor size 1.3 cm, no node involvement, had surgery and mammosite radiation, and now looking at chemo.  (Originally diagnosed in March 2009, had surgery and mammosite in April 2009. I am ER positive, PR neg and HER neg)   Had an oncotype score of 41, which I understand is pretty high.  My oncologist originally recommended AC every 3 weeks for 4 cycles, and Taxol for 12 weeks on a weekly basis; I objected to the 12 weeks of Taxol, and now he recommends  TAC treatment for 6 cycles, mainly, I understand, because of the high Oncotype score, which he feels puts me at high risk even though I am node negative.    I am really unsure if this is overkill--should I seek a 2nd opinion?  I am concerned about toxicity, and of course, quality of life issues.  thanks for your input.

[maia1]

A related discussion, would you recommend chemotherapy in my case? was started.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
TAC for 6 cycles is a perfectly valid regimen to choose.
There is no good data to suggest that 4xAC-->12 weekly Paclitaxel is better than 6xTAC, although the adverse effect profile may be different for the two regimens.
You may like to discuss with your oncologist the option of TAC.
Good Luck!

[Debbie1987]

Do you think there is any significant difference in the original recommendation (AC for 4 cycles, followed by a Taxol drug  for 12 weeks on a weekly basis) vs. TAC for 6 cycles?  I am obviously much more comfortable with the TAC for 6 cycles from an emotional and psychological standpoint, but still want to do the right thing.  thanks so much for your earlier response--it was very helpful.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
As per current treatment guidelines, chemotherapy is recommended for stage 1 breast cancer with tumor size more than 1 cm or an HER-2 positive tumor with tumor size > 0.5 cm. A high Oncotype Dx score is associated with higher chances of tumor recurrence. Therefore chemotherapy is indicated in your case. The regimen your oncologist has recommended is consistent with current treatment guidelines. Most of the toxicity associated with chemotherapy is temporary and there are various drugs available to reduce the side effects.
All the best, and God Bless!