Please answer a question about chemo

I had triple positive breast cancer, a mixed tumor ( a little of this and a little of that), in 2008, and I had 4XAC 12XT(Taxol)H, followed by 2 years of Herceptin.  I was Stage 2 Grade 2 and had a bmx with one big lymph node.  

There was a trial underway to compare TCH with ACTH, because the Adriamycin is added toxicity and the Herceptin is your major player if you are Her2 positive.  I was told in 2009 that the study trend lines converged and there is (was at that time) little difference in the efficacy of the two treatments.  However, the study was not complete but may be now.

I believe that doctors have their own opinions on one course or another based on the patients they see, age, lifestyles, and other things they don't always tell us in detail.  I think that because my tumor was mixed and my er/pr both 90%, the adriamycin was preferable because it's the old reliable general cancer cell killer.  Today, the treatment might be more selective.

Warmly,

Cathy 

AC-T was recommended for me at Mayo.  4 rounds of AC, followed by 12 rounds of Taxol.

I'm presently doing TCH X 6. 

I asked my onc why the different protocol.  He said that chemo drug choice is somewhat regional.  And that Mayo typically recommends AC-T.  But he preferred TCH because of the reduced cardiotoxicity and the leukemia risk.  I'm 35 and have a good number of years ahead of me!  He said that he would give me AC-T if I really wanted it - it would be a reasonable procotol.  He said that oncologists sit in board rooms and argue this very point.  AC-T is 1-2% more effective, but to him the benefit didn't outweigh the risks associated with it.

I had TCH x 6 as my onc said they use AC-TH for node positive patients only

I wouldn't think a specialist in Her2+ is necessary for non-metastatic BC.  The treatments are so standard, and Her2+ is prevalent enough (15-20% of BC), that just about all oncs who treat BC should have plently of experience administering these protocols.

I am ER/PR- and HER2+. I am on the AC TH regimen.   I think the other thing to consider is that because  she is hormone positive (ER/PR +) she will most likely have other drugs to take besides chemotherapy.  

best wishes to your coleague.

Taxol and Herceptin is approved for metastic Her2+ already. My onc puts people on that. He has one patient that has been alive for over 10 years and she's on that now.

I think the difference with Ac v/s TCH is the stage and er/pr- or+. The er- is harder to treat and more agressive warrenting a harsher chemo (TC) and Herceptin is a standard for Her2+. The TC causes neuropathy that can be permanant.