Anybody NOT have dose dense?

TexasRose -- I did not have dose dense -- I had the classic TAC (6 cycles/every 3 weeks) however my chemo was neoadjuvant (i.e., before my surgery). The T in my case was Taxotere.  My initial diagnosis was Stage III, Grade 3, TN.  My tumor was over 10cm originally (before the excisional biopsy of about 4cm).  I had surgery recently - mx and 16 nodes removed.  My results were complete clinical and pathological response -- no evidence of disease -- in the breast tissue and all nodes removed.  I had scans before the surgery and they were all clean.  I have read many journal articles on this subject and did not get the sense that dose dense is the gold standard -- it is merely one of the current treatment modalities. 

 If you look at the statistics of all cancer patients combined your onc is right, does dense AC is not much better than the once every 3 weeks AC.  But remember that triple negative is only 15% of total, and that chemotherapy doesn't impact hormone positive cancers much anyway.  When the effectiveness of does dense compared to traditional once every 3 weeks chemo is considered for only triple negative breast cancer patients it is striking how much more effective the dose dense is over the once every three weeks. 

While zuffa and becca743 didn't get dose dense AC they also did not get once every 3 weeks AC.  TAC is hardly a classic treatment.  TAC is a 6 treatments of all three chemos at once delivered once every three weeks.  The 'classic' treatment is 4 treatments of AC once every three weeks followed by 4 treatments of T once every three weeks.  TAC and dose dense are both considered to be 3rd generation regimens and appear to be equally effective (but it seems like the larger the tumor and/or more nodes involved the more likely TAC will be used over dose dense AC, and that the side effects of TAC are alittle more severe).  

 AC once every 3 weeks is a 2nd generation chemotherapy treatment.  Because chemo is so effective against triple negative (versus almost ineffective against hormone positive), most triple negative patients get a 3rd generation chemo. See https://www.adjuvantonline.com/ for a comparison of the impact of the different types of chemo on your particular characteristics.

 I recommend you continue to push for dose dense treatment (if for no other reason you get done 2 months faster!) or TAC. Stay in the Avastin trial if you can, especially given it sounds like it is supposed to be given with weekly Taxol.  I am confused why your onc would push the old chemo, could it be the only way you can qualify for the Avastin trial is if you do the classic AC every 3 weeks? .

As for an east coast thing, that is hogwash,  I was treated at the Fred Hutchinson Cancer Center in Washington several years ago and while they still have AC every 3 weeks to hormone positive patients, triple negative patients were pushed hard to take a 3rd generation chemo. What I have noticed is that it is typically oncs in small towns that still give the old chemo, but large teaching hospitals, and oncs that specialize in only breasts do not.

I received Taxotere and Carboplatin together every 3 weeks for 6 sessions.  I was told that the Taxotere had been shown to be as effective as Taxol and had fewer side effects.  I was happy to have the 2 week rest periods.  My life was relatively normal during those two weeks.  I was offered an experimental trial of Taxotere plus Carboplatin and taxol and carboplatin or some other c chemo every two weeks for 8 weeks. (TIC TAC study)  It sounded pretty rough so I opted out of that trial.  I'm hoping that by vamping up my diet and exercise post chemo I'll have done myself as much good as any extra toxins they might have thrown at me.  My oncologist was very supportive about a diet and exercise program.  He said some studies even indicated it was as good as chemo and that it reduces recurrence by 50%.  He assured me that my TIC cycles times 6 were state of the art for 2009. I received treatment at the Cancer Center in St. Thomas Hospital in Nashville, TN.  My young Oncologist was trained at John's Hopkins and seems to be constantly on top of the latest research so I trust his judgment.

Hi TexasRose,

I did DD A/C and 12 taxols....I also did the Avastin trial, E5103.  I live in Kansas.  If you want some info on this trial and what to expect go to "help me through treatment" and look for the thread Clinical trial E5103....I would be happy to tell you what I know just PM me if you would like to.

Teresa