FEC-D versus TC

Coupon · October 2016

Hi there,

I had met with my MO after left mastectomy. He recommended FEC-D or 4 cycles of TC. Is there anyone encountered this? I understand the toxicity for FEC-D is higher than TC but is it beneficial to bear the risk of long-term cardiac toxicity?

Any advice is valuable to a newbie like me.

Thanks!

KBeee · October 2016

It probably depends on how high of a risk they think you are for recurrence. If they did the oncotype and it was moderate, then maybe TC would be appropriate, but if it's high, them maybe the FEC-D. What does your MO recommend? Can you get a second opinion? Also consider whether or not there is a significant cardiac disease risk in your family.

CatsRus · October 2016

I was offered 6 rounds ACT or 4 TC but my MO gave me percentage benefits. For me the ACT only offered an extra 1 or 2% advantage and I decided that for that small an amount I wouldn't risk the potential heart issues and went for the 4. Rounds if TC. For me chemo was added insurance, the hormone blocker (Letrozole) was my main defence against recurrence. Good luck to you...ask your MO as many questions as you need to make your best decision. Be well.

Coupon · October 2016

Thanks CatsRus & KBeee for your response.

In Ontario, Oncotype test would not be ordered if there is any node involvement. I wish I could find out my score too!

My MO actually recommended 3 regimen choices:

FEC-D
ddAC -Taxol
TC

Since ddAC-Taxol has higher chance causing heart problems + leukemia, he is more inclined to go with FEC-D for me. He had sent me for the echo cardiography test, waiting to see if my heart can tolerate FEC-D or not.

Having said that, I had further looked up the NHSPredict calculator and compared the ℅ with respect to 2nd generation versus 3rd generation chemo regimen, the predicted 5 year survival only yields an extra 1% but predicted 10 year survival stays the same. Like CatsRus mentioned, I am wondering the benefit of FEC-D may not be outweighed by its toxicity, especially the potential heart issues. I have strong ER+ & strong PR+, even though there is 1 lymph node involved, my MO mentioned hormone therapy would reduce the probability of recurrence by half. I am wondering if I would be benefit from the chemo at all. I am still not totally on board with it. Will definitely ask MO on my next visit.

CatsRus · October 2016

Your dx is very similar to mine. I also had one node involved. I was also told the AI reduced by risk by 50% so taking that is a no brainer. I also had a high % ER+ PR+. I considered not doing chemo but felt I needed to do as much as I could. that's why I opted for the 4 TC. I agonized over it for a while but in the end I was happy with my decision. It's tough, you don't want to do too much but you want to do enough. I didn't need radiation and was thankful for that

FEC-D versus TC

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