Which one?

[smokey 234]

I have received a second opinion about my chemo.  Though both doctors agree on the diagnosis of Stage 2A node neg. lobular cancer,  her2 - espr+  they have different opinions about which chemo.  One is dose dense AC + T, the other recommends CAF (6 treatments). I am trying to find out as much as I can about both, as quickly as I can.  Are the side effects worse with one or the other?  What about survival rates for my cancer.  Oh the person who recommended AC + T said she did so because although it has not been studied on node neg. women, she feels as if she would comfortably recommend it for people with a smaller tumor and one node + and my risk is the same as theirs.  The other doctor did not recommend it because it has not been studied on node negative women.  I'd appreciate any help and or info. you can give me.
thank you

[CCF-RN,MSN-rf]

Dear smokey 234:  Neither recommendation is wrong, just different.  CAF used to be the standard of care.  Now, many centers use AC with or without T, depending on risk.  Dose dense AC+T was introduced recently in high risk breast cancer and did demonstrate a survival advantage.  It is not known whether there would be any survival advantage in women with lower risk disease.  There is currently a national trial for node negative breast cancer comparing AC (2 different schedules) to Taxol (2 different schedules) as adjuvant therapy.  So, as you see, it is not yet known what chemotherapy is superior (if there is one).  You should go with the physician you feel most comfortable with.  Another option is to seek a third opinion.  Either way, I would expect you to be on tamoxifen following your chemotherapy.

[smokey 234]

About tamoxifen, one doctor recommended tamoxifen for 5 yrs, and then something else, but the other one recommended armidex.  So that is the next thing I have to research.

[Twocapes]

Tamoxifen vs. Arimidex - I think it depends on whether you are pre or postmenopausal and, of course, being ER positive.