Does anyone know

my clinical trial was using the combination of TAC...that was in 2002. it seemed after the trials the use of taxines became standard for lots of nodes positive.  i felt pretty lucky to be a part of that trial and got the good chemo.  still NED.....

Since my original diagnosis in 2001:

a. Oncotype Dx, for node negative and most recently for node+ (1+,low grade or such): gene profiling your own tumor tissue for specifics unique to you so therapy can be personalized from results. Being aware of your ER/PR result and your Ki-67 numerical result with discussion with your treating oncologist.

b. Dose dense chemotherapy (q2 weeks yields better OS than q3 weeks)

c. Taxane family regimen: TAC rather than AC then T for improved DFS (T= docetaxol, also taxol and placitaxol

d. TC often replacing TAC or AC-T when cardiotoxicity of issue (answer still not complete)

e. Neoadjuvant chemotherapy to reduce disease and allow lumpectomy in select patients

f. Hormone therapy for ER/PR+ patients with low oncotype and some in gray zone per risk/benefit

g. Neoadjuvant hormonal therapy with gene analysis- ongoing research

h. Zometa IV for premenopausal women to help reduce metastasis (still unclear about postmenopausal women)

g. Nipple sparing mastectomy- with greatly modified surgical scar

h. SLN alone or with few fellow lymph nodes with return of negative pathologic findings on final exam- still under study but seems this may help reduce ALND.

i. PET/CT scan upon diagnosis in select cases to ensure correct staging

j. Mammogram, MRI combination with breast mass preoperatively for elucidation of extent of breast involvement.

k. Extension of hormonal therapy past 5 years in select cases (grade III, node positive)- still under study but also used at onocologist/patient discretion with informed consent

g. Verification that AI's are + associated with carpel tunnel syndrome, arthalgias, muscle and bone pain, partially through confirmation of tenosynovitis of joints on MRI. This was major confirmation of complaints of AI users not picked up in original ATAC trials.

h. Extension of Herceptin use past first year in certain cases; development of Tykerb, 

g. Verification that even isolated cells in SNL/other strongly suggest treatment with chemotherapy or hormone therapy in small tumors

i. Introduction of kinase therapies: to attack cancer cell division through protein production modification 

j. Consideration of checking one's Tamoxifen metabolizing ability prior to onset of treatment by submitting blood for CYPD6, with counseling about one's status as well as suggested co-drug advoidances- still contraversial but less so than years ago.

k. Triple negative disease: very chemotherapy sensitive, with new insight to the value of platinum drugs.

l. Oral carbecitabene (Xeloda), a second oral chemotherapy (cyclophosamide is also oral) which limits hair loss

k. More, but I've run out of steam, perhaps others might add to the list?

 Looking back it seems light years ago since my treatment, given all the developments, for which I am very thankful for for my sisters and brothers.

Tender

PS: please feel free to copy and past and add on. You could even organize by subsections should someone wish. Best, Tender

That is a great list Tender!  And it is inspiring to see all the changes.  I needed something positive like this.  To remind me why I signed up for a trial using Sutent/Taxol and then AC.  Had my last taxol tx last Monday and took my last Sutent about 30 minutes ago.  Getting a week break then start 15 weeks of AC.  Reviewed the SEs of taxol and Sutent last night and it seems like I got most of them in varying degrees.  It was hard.  And prospect of 15 weekly ACs in front of me is daunting.  This trial may or may not pan out, but your list is evidence of why we do this.

Here's to hoping in 5 years we get to add to the list with a protocol that cures the cancer.  Zero re-occurrence and zero mets. 

Not wanting to get political here, thanks.....