TC versus ACT for IDC???

TCX4 has been shown to be more effective than ACX4. Unfortunately I don't think there have been head to head studies of TC and AC+T. Maybe someone can correct me on that. There is currently controversy about the use of A so many oncologist (led by the folks at UCLA) no longer use A with ER+ Her2- patients.  Partly the controversy is over whether A works at all for people without some specific gene that Her2 may be a marker for, and partly it is over whether the risk of heart damage justifies using something that is not more effective. The risk of damage to your heart is higher with AC. It is typical that the oncologist would let you choose, given your diagnosis, because both are being used and seem to have anticipated results. Did you have chemo with your first diagnosis? There is a lifetime limit on how much A you are allowed to have.

Sea_nymph ~  So sorry about your recurrence.  Did you have chemo the first time?  

My first inclination in answering your question was to say, definitely TCx4 because I'm actually being treated @ UCLA, had TC myself, so am familiar with their thinking about Adriamycin.  As Revcat said, unless you are Her+, the benefit of Adriamycin may not be worth the potential risk.  However, since this is a recurrence, I think what you did before -- if you had chemo -- needs to be considered now, although maybe you didn't have chemo the first time.  I'm also not sure if the fact this is a recurrence alters the validity of an Oncotype-DX test either, but it seems like your bc has already told you it needs chemo!

If you're interested and PM me, I can give you a link to a UCLA video that explains a lot about chemo for breast cancer, including some recurrence stats, as well as why they have stopped using Adriamycin in many cases.  Do you know how to send a Private Message yet?  Just click on any member's screen i.d., and it will take you to a page with an option of sending them a Private Message, which is like our own private email system here.  It will save you a post, which are limited to 5 per 24 hrs. when you're new.     Deanna

Sea-nymph ~  From what you've told us, your situation is highly unusual.  Did either pathology --from your biopsy or your surgery -- show any IDC mixed in with the DCIS?  As you probably know, DCIS doesn't travel outside the ducts, but the fact that your recurrence is at the biopsy site makes it seem like you must have had it initially. 

I totally agree that you need not only a second opinion, but ideally one at an NCI-designated cancer center.  I don't know where you're located, but here's a map of where those top facilities are:  http://cancercenters.cancer.gov/cancer_centers/map-cancer-centers.html

If there's an NCI facility anywhere near you, you might want to post a separate question asking for recommendations re. the oncologists there.  If not, you might want to post the same question for a recommendation in your general area.  But my philosophy is, whenever something about a situation sounds the least bit uncommon, that's when you really need the top centers, because they see far more bc than most hospitals, so have likely had experience with whatever is unusual about your situation.  And this is a situation where experience can made a big difference.     Deanna

Hi Maybe I can help a little - looks like we have similiar diagnoses and i had my first infusion today. My onc is the clinical director at mgh.dana farber Ca center in Boston and JUST reviewed this w/ me today. TC is just as good as AC - no research on tc + a but the consensus is the side effects both long and short term don't seem to justify using Adriamyacin w/ our dx. I chose TC and feel pretty good tonight. Be at peace w/ whatever you choose. Valerie

PS had surgery, going for rads and arimedex and the liklihood of recurrence w/ all that is slated at 14%. Good Luck to you!