What chemo treatment did you choose with your BRCA2+ dx?

segunda

I am 49, BRCA2+, triple negative, 1cm IDC, nodes clear, had BMX. I am being asked to choose between ACT and TC. What did you choose for chemo? Did you do chemo? I understand ACT can damage heart and risks leukemia. My BS says ACT and TC do the same thing, and I should go with TC. My MO is still in two minds and wants to look at my actual tumor slides first. My mamma print says I my tumor is high risk basal-type, and the risk of second cancer goes down from 29% to 9% with chemo.

MiniMacsMom

i had a umx locally and after found out i had tumor and lymphs left that had been missed.  i followed mda protocol not knowing at the time i was brca 2 pos.  i did 12 weeklu taxol and then 4x3 fac.   i has a resection surgery after and has complete response in my leftover cancer.   this protocol is longer than tac but overall easier on the body.  on a side not i have  read that brca tumor respond well to platinum drugs like carboplatin and cisplatin.  if possible i would get a second opinion from an mo who specializes in hereditary cancers.

segunda

Thanks, MiniMacsMom! Glad to know you had a complete response! I notice you are positive for ER & P, while I am triple negative, so I wonder if that's why our doctors gave us different choices. I will check with an MO who does hereditary cancers. Thanks!

Leigh74

I am not triple negative either but I am doing TCx4 for a <1cm, node negative, ER+ stage 1 cancer. I had #1 and #2 already and did quite well. However, I would really want the hard evidence as the what triple negative responds best to. I have two friends with triple neg and they were both TOLD ACT but they both had stage 3 cancers. It seems that Adromyc is a harsher treatment in terms of recovery but I would want what is the most effective

segunda

Thanks, Leigh74. I am hoping my MO also tells me to just do the TCx4. My breast surgeon thinks I should do the TC because I am node negative, like you. He thinks ACT and TC will do the same thing of for me, but ACT of course is more damaging. So I am just waiting for the MO to finish her studies of my pathology slides. Hope things go well with the rest of your treatments! All best!

segunda

Just heard from my oncologist. She prefers ACT, though is okay with TC because of my concerns about heart damage. She says there is a slightly higher percentage of better prognosis with ACT, but both ACT and TC do the same thing—lower risk of a second cancer. I am now in 2 minds, though currently I am going with TC. Still doing research.

QuinnCat

Segunda - see my profile below. I had AC/T dose dense (every 2 weeks). Then I had 6 weeks of Carboplatin, though only completed 5/6 due to neuropathy from T and Carbo. I went to an NCI hospital (OHSU) and the Lead MO believes in Carboplatin for brca+ patients because they are effective on the type of cancer that results from lacking that tumor suppressor gene. I also had a high oncotype score, stage 1, and the "throw the kitchen sink at it now" theory applied in my case, though, I think this MO gives carboplatin, in addition to conventional chemo, to all of his brca patients. It was 5 months of chemo though. I walked and walked throughout and a year later feeling good.

I had a discussion with another brca woman her at BCO going to MDA. They would not add it to their "strict" protocol. Dana Farber does. Last I heard, they didn't get the recruitment levels they needed to test it, but plenty of anecdotal evidence that platins are highly effective in brca women. One small Polish study had very good results. There is currently a Clinical trial for a PARP inhibitor, for Stage IV, by BioMarin. Another promising "chemo" for brca.

daffyc

I did AC/T dose dense chemo. My chemo was neoadjuvant and I did not have BRCA results yet. I DO have lymph involvement, known from my initial biopsy (where I discovered the bc). I also had a possible small liver met so the thought with both my first and second opinions was to get chemo going asap. My BRCA results came about during my chemo treatment.

segunda

thanks so much, guys. just got back on the boards. what happened was I asked a doctor researcher friend at U Chicago hospital to ask the breast cancer specialists there what they thought. All 3 said TC for my particular profile (a few differences among us, Kam170 and daffyc, which perhaps explains their choice?). My breast surgeon also said TC. The main reason for not choosing ACT, for them, was the danger of blood disease (leukemia) with ACT (it is in my family history) given that TC offers me just as good a chance, given my profile (node-negative thus no mets, and so on). My onco says if I were not node-negative, there would be no question I would be doing ACT. So I am doing 4 TC rounds, 1 every 21 days. It was illuminating to hear about your diagnoses, as the differences are interesting. Hope you guys are doing well. I have finished my second dose, and while a drag, I am looking forward to finishing in January. All my best!