dose dense vs conventional chemo

[LarryS1751]

My wife has a IIIa apocrine carcinoma HER2 neg ERPR neg, biopsied but not resected. Nottingham 6. PET CT shows a couple of nodes in the axilla but no biopsy. The plan is for neoadjuvant RX followed  by mastectomy and radiation. She is 52. Our local oncologist who is very well respected and works in a university setting has not embraced the dose dense treatment. I spoke with Cliff Hudis at Memorial Sloan Kettering who was quite confident that AC-T dose dense is the best treatment. I discussed this with our local oncologist who feels the risk of infection is too high and the statistics don't support the dose dense regimen. The question is do the risks of dose dense Rx outway the risks? Is this now the accepted protocol? The oncologist's feeling was only East coast docs were still using it. This is all very confusing and we want to make the right choice here. Thanks to anyone who can help clear this up.

[CCF-RN,MSN-rf]

Dear LarryS1751:  For the post-operative adjuvant setting for node positive, hormone receptor negative breast cancer patients, dose-dense AC-T has shown itself to be superior to the same treatment regimen given every 3 weeks.  Dose-dense AC-T has not been formally tested for preoperative treatment, but is a reasonable option.   You may benefit by seeking a second opinion.