What the norm for chemo with TNC?

I had dose dense ac and t.....ac 4 times every two weeks, then 4 taxol...sounds like your onc is giving you the maximum..which is a good thing...good luck to you!

I had 3 months AC and 3 months taxotere. Just a question, have your doctors given you a bone scan? I had clear nodes, but bone mets occurred! Anyone else out there like me? Are bone scans done with TNBC cuz it is so aggressive, please help. Hugs, Renae

Debbie, I had 12 weekly taxol and then 4 AC, every 3 weeks.  I am curious why you are doing 12 weekly FAC. I have heard it is best to do smaller amounts of chemo closer together, rather than a large amount at a time spaced farther apart, but have not heard of anyone doing 12 weekly FAC.  I am curious to why you are doing FAC, FEC is usually more common.  Most TNs I know of had the AC part (Doxorubicin, Cyclophosphamide), but not the F (Fluorouracil), and if they had the F it was FEC not FAC.  

Renae64, I had a pet scan and a bone scan. The reason for the PET was they were trying to stage me prior to beginning neoadjuvant chemo, and when a place lit up on my back, they did a bone scan to figure out if it was a bone met or arthritis.  Thankfully, it was shown to be arthritis.  I know many TNs who do not get staging scans of any kind, unless they have an affected node or other concerns.  Insurance doesn't seem to want to pay for these scans unless they believe it is warranted.

I am triple negative and had six treatments of taxotere and cytoxan three weeks apart. Sometimes treatment differs by where you Sre in the country. Also I had a ver small tumor no Lvi and neg nodes.

Oh ok, you are doing the FAC every 3 weeks.  I live in Corpus Christi and followed the MDA protocol for TNBC.  at that time (July 2011), it was 12 weeks of Taxol, then 4 rounds of AC every 3 weeks.  Most TNs I knew where doing Dose Dense AC, meaning AC every 2 weeks instead of every 3, so I asked my Oncologist if I could do dose dense.  She said that we are following the MDA protocol and that places that follow Dana Farber or Sloan Kettering protocol are doing dose dense. Yes the weekly Taxol was far easier for me.  I had 33 radiation treatments and that was easy for me; the driving to radiation everyday seemed to be the biggest pain about it.

About your question: Can TNC grow another tumor in 2 months time.  From what I have read and heard from TN sisters, yes, oh yes it can.  TN seems to be one of the fastest growing. SOme women say that between mammogram and surgery (about 1 month) their tumor doubled in size.  Although it is one of the fastest growing with rapidly dividing cells, it is also usually quite responsive to chemo.  Most chemo works on killing rapidly dividing cells and that is just what we have.

Debbie, I also suggest that if there is anything you are uncomfortable with, speak up! get a second opinion! You have to be your own advocate, the squeaky wheel gets the oil. Don't be afraid of speaking your mind, ask your drs what they would suggest for their loved ones.  Our health care is only as good as our weakest link.  Don't let that be YOU! Good luck to you.  Wishing you a complete response from chemo and few side effects.  

I had 4 rounds of AC..then I just finished 33 rads..It feels sort of odd not having a saftey net anymore.

I had ACT for 12 weeks, except the last week I could not take the taxol since I was accumulating so much fluid.  I am hoping this does not make a difference.  Good luck!

I had dose dense (every other week) A/C 4x followed by dose dense Taxol 4x and then 35 rads...

Hi, I'm having 6 FEC-T every 3 weeks but when I see my oncologist on wed. I'm going to ak about dose dense. I also see most women are getting AC,so I'm wondering about that as well. Any advise ?

That ITPLD sounds exciting - I have not heard of it on these boards to be a common treatment, but you can place it in the seach criteria and see if there are conversations about it.  That should be a reminder to us to try to limit our sugar!

Hi Debbie,

My chemo consisted of 4 rounds of Adriamycin and Cytoxen every 2 weeks, then 12 weekly sessions of Taxol.  If you have questions about the chemo your doctor is prescribing you could always get a second opinion.  However you are being treated at an excellent facility so I'm sure the chemo they are recommending is appropriate.  Hope everything goes well with your treatment and the side effects are minimal.  I found the weekly taxol to be easily tolerated.  I was able to work, though at somewhat reduced hours, during this time.

slv58: FEC-D is equivalent to AC-T and a very common regimen in countries other than the US. It is the big guns, though is "E" is gentler on the heart than "A." I had a long conversation about my onc about this, as I wanted to do dose dense for TN. She had no issue, but it was a bit unusual at the time, and perhaps still is in Canada. To my knowledge there has been no head-to-head study of triweekly FEC-D versus dd AC-T.    

To my knowledge, there is not one standard treatment for TNBC, such as the case in point of "dose dense."  If you open up the NCCN Guidelines Manual, there is not a reference of it in there.  Also, this is one of those things that is up for debate, as it depends on if someone is high risk, and stage of BC.  Not all Oncologists recommend the most aggressive treatment if they believe another treatment would be just as effective without the risks. I think anyone mentioning dose dense as a standard is really putting themselves out there on a limb, unless they are an MD making that statement. Each person comes to the table with a whole set is circumstances and must be evaluated and treated not only due to guidelines but also to personal direct risk factors.  Family history, stage, location, age, health, risk factors, etc are analyzed when a treatment plan is presented to the patient. 

I had dose-intensified treatment, which was CT treatment every 3 weeks, but at a 60% higher dosage.

Now - Per the NCCN guidelines, for the characteristics of TNBC that I had, regarding my path report, here is what was referenced for the Preferred Adjuvant Regimens - as you can see, they referenced four different acceptable protocols for the category/stage/etc that my pathology report referenced.  

So these aren't for other stages/other types, etc.  This one excerpt below, is for treating TNBC according to what was in my pathology report.

It also includes dosing recommendations in this manual as well.  That's something we don't hear about on these boards a lot, is what dosage did everybody have. 

From page 44 of the NCCN guidelines, version dated:  7/11/2012:

ADJUVANT CHEMOTHERAPY1,2,3,4,5

Non-trastuzumab Containing Regimens (all Category 1)

Preferred Adjuvant Regimens:

                  ·  TAC (docetaxel/doxorubicin/cyclophosphamide)

                  ·  Dose-dense AC (doxorubicin/cyclophosphamide) followed by paclitaxel every 2 weeks

                  ·  AC (doxorubicin/cyclophosphamide) followed by weekly paclitaxel

                  ·  TC (docetaxel and cyclophosphamide) 

I had Cytoxan and Taxotere, 4 rounds 3 weeks apart. My oncologist felt this would be sufficient based on my situation, it was a small tumor and no spread to the nodes.