TC vs. TAC must decide!

Hi Susan,

My story is in other places here on the ILC boards, but since you are in a hurry I'll share it here briefly.  I had lots of tumor in my breast, small nodules were spread over an 8cm area.  One conglomerate of nodules was at least 2.1 cm and the "tumor bed" after chemo was bigger than that but they don't know because of the chemo effects.  I had individual cells in 3 of 9 nodes they looked at, one of these nodes had a cluster of about 1mm so I guess that could be called positive.  I had a sentinel node biopsy before chemo.  My cells had "moderately pleomorphic" nuclei instead of the small nuclei in Grade 1 lobular, so it was called "lobular with features of pleomorphic lobular",  PILC.  My oncologist (and second opinion also) recommended AC at 2 week intervals. I ended up having 6 of these infusions because after 4 treatments my mastectomy pathology showed residual viable cancer cells.  Response was estimated at 95% + though by MRI and pathology, so that is a very good response.  I think that shows that at least some lobular responds well to AC.  Most people don't do this, but I had chemosensitivity tests done on the residual cancer to see if another chemo would work better than AC.  The tests showed that the cells would continue to respond to AC, but not any of the taxanes, platinums, or "beans".  That's why my last two chemos were AC, too.

Nobody I have spoken with knows what markers indicate one chemo will work better than another.  My oncologist thought I would respond because in his experience pleomorphic lobular does, but he was very pleased that it responded so well.  It's really terrible to have to decide.   I think if I were being treated today instead of back in 2005 my oncologists may have recommended TC.  I am glad they didn't.  My oncotype DX was 23.  My ER was strongly positive by IHC but only 8.3 by Oncotype.  My PR was negative by IHC and 5.8 (barely positive) by Oncotype.  I don't know if hormone receptor levels matter, but I read in a few articles that low ER cancers may respond better to chemo. 

This turned out to be a longer post than I thought.  Anyway, whatever decision you make, based on what the experts are telling you and your research, be a peace with it.  It's helped me to feel that I did what I thought was right at the time.  I've read that others feel that way, too.  Somehow we seem to feel inside, somewhat, what we should do.  

All the very best, HUGS, G. 

I'd be a bit wary of a family history of heart disease with respect to A also, especially since you're rather young to show heart problems yet. That was one factor in my decision to avoid it, but there are cases like Gitane's where it works very well. A tough call.

Other cnacers are possible side effects from almost all the chemos. A lot depends on your previous exposure to other carcinogens, such as I found out that people in the printing industry who are heavily exposed to benzene (a known carcinogen) have a higher risk of developing leukemia after taking cytoxin for another cancer...such as breast cancer.

I don't work directly in printing, but I'm in a related industry and was probably exposed to benzene more than I know. Also, I used to use rubber cement and thinner which contain toluene, also a carcinogen.