Is 3rd generation chemo beneficial for node negative patient?

andrew_van

Is 3rd generation chemo beneficial for node negative patient?

andrew_van

Hi,

Has anyone with node negative has been recommended 3rd generation chemo?

3rd generation :

TAC x 6

CA x 4 then T x4

FEC x 4 then T x8 

FEC x 3 then D x 3

(D= Docetaxel) (T=Taxotere)

What do your oncologist think about it?

Thank you. 

nash

I'm node negative, and my onc recommended TACx6. The second opinion onc and the surgeon both said that was overkill, and recommended ACx4. I felt that wasn't enough, so went with a middle ground 2nd generation chemo of CAFx6.

andrew_van

Hi,

I got the same problem. He said that 3rd regimen would be overkill so she got CEF x 6.

But I heard that for example that FEC x 3 follow but D x 3 is a third regimen and is better than CEF.

Also less long term side-effects because there is two group (FEC and D).

Chemo is complecated and I guess this is why oncologist as their own guide sometimes. They would go crazy if they start analysing every possibities.

nash

Andrew, I've been told and have also read that the overkill part of the equation for node negative is are the taxanes. I think the FEC x3 D x3 is an interesting approach, however, and I wonder if it's a relatively new way to dose. It wasn't offered to me last August when I started chemo, but sounds like something I would have considered. And you're right--chemo is complicated. I'm not sure how we're supposed to make decisions about it when the oncs can't agree amongst themselves.

LisaSDCA

I'm node negative but I did do 3rd gen. and I welcomed it! I did TACx6 and would have taken anything stronger if a 4th gen. had happened down the pike at the last minute. Node neg. is not the only variable to look at. I am triple negative - many oncologists view that as equivalent to a positive node. Also, the nodes are not the only avenue for spread beyond the primary tumor. A careful reading of the pathology report can indicate whether there was any lymphatic/vascular invasion in the area of the tumor bed itself. In my case it was absent in one and present in the other. Another telling variable is the Grade of the carcinoma. A Grade 1 indicates a slow-growing, well-differentiated tumor cell. A Grade 3, even in a tumor of the same size, location, node neg, etc. is an entirely different beast. It indicates poorly differentiated cells, likely to be highly aggressive and fast growing. Add in a pre-menopausal patient and there's even greater llikelihood of an aggrresive tumor.

These are just some of the factors that might be used in suggesting a Gen.3 protocol in node neg. breast cancer, even w/ small tumors - and why some of us might jump at the opportunity. I do like it when an oncologist thoroughly analyzes the possibilites.

nash

You're absolutely right, Lisa. High-risk node negative bc calls for a taxane. Thanks for bringing that up.

My situation was so solidly in the grey area that it took 4 trips to tumor board and a call by my onc to UCLA to decide what to do with my chemo. I was young, had a large tumor of a rare, clinically aggressive subtype, yet had negative nodes, hormone positive, grade 2, oncotype 18. My second opinion onc walked in the room upon our first meeting, looked at me and said, "You're a conundrum". Terrific. Anyhow, ultimately the consensus was that risk of a taxane outweighed the benefit in my case. 

Dorbeth

could you tell me what your abbreviations mean????

Hildy910

Or what third generation chemo means?

jenlee

Here is a pretty simple explanation of the various types of of chemo used for breast cancer:

http://ww5.komen.org/BreastCancer/TheChemotherapyDrugs.html




I was node negative, but my tumor was almost 4 cm and very aggressive -- grade 3 and Ki67 75%. The plan was for TAC x 6, but after two cycles, i was offered TAC x 8, based on the results of the GeparTrio Trial. I agreed to try it and the invasive part of my tumor had a 100% response to chemo, leaving behind some DCIS (which wouldn't have responded to chemo). After chemo, had a BMX. Another cancer center recommended lumpectomy and radiation. I'm VERY glad that I chose the most aggressive route!

HugoTorres

Hello, Ms Jenlee.

My wife, 33, has been diagnosed breast cancer ductal carcinoma, grade 3, 100 % hormone and strogen, the tumor is 12 mm -the longest filament- and the KI67 is 18% now. Her CT has showed no other parts of her body are affected. Our doctor has suggested Mammaprint test to consider chemo, but I fear that very small molecules could have spread to other parts, Maybe choose the chemo plus the hormone therapy would be safer regardless the results of the genomic test. What is your opinion?