AC-T or TC?

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Laurenann78
Laurenann78 Member Posts: 9
edited November 2016 in Young With Breast Cancer

I have a stage 1a, 1cm IDC, grade 2 with mitotic rate of 1, with clear nodes and large (>10mm)clear margins-ER + (100% based on biopsy sample) PR-/HER 2-. I was a bit shocked when I had a visit with the MO and she recommended I have chemo. I had been told several times it would be unlikely I would need it. She said because I am young (38) and PR -, I should take it into consideration. I asked her to send the Mammaprint and am awaiting the results. However, even if I come back high risk, I am unsure that I am willing to take the Adriamycin due to the risks associated with it. Has anyone else declined and done TC only? Or if you had TC only recommended, why did they recommend that over AC-T? I am getting a second opinion as well and possibly a 3rd. Thanks in advance for your thoughts!

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  • Hopfull2
    Hopfull2 Member Posts: 418
    edited November 2016

    Hi laurenann78. I am37 and have stage 1A bc ER+ PR-,HER2-. Tumor size 7mm and clear lymph nodes with 1 having micro invasions but still considered clear .I was almost sure I was not going to need chemo after my masectomy. But they did the onco test and my number was high. So chemo it is. I will have my 1st infusion November 10th. My Dr. Recommended T/C 6 rounds every 3weeks. He said that AC is cardio toxic. I sent my question to john Hopkins breast center and they too said that TC is thier 1st recommendation with my stage and then type of cancer And they too Said AC is cardio toxic. So I chose to go with TC .Hope this helps and seek a 2nd opinion.

  • Sjacobs146
    Sjacobs146 Member Posts: 770
    edited November 2016

    my doc recommended TC and not ACT because of the risk of developing leukemia from the Adriamycin. My Oncotype was intermediate, but I had a positive node, so doc recommended chemo

  • tennischick888
    tennischick888 Member Posts: 18
    edited November 2016

    Laurenann78 Did you get Oncotype test? I am glad you are getting other opinions. I would too. Good luck

  • Laurenann78
    Laurenann78 Member Posts: 9
    edited November 2016

    I just got my Mammaprint back today as a low risk! I'm deferring chemo and moving forward with radiation and ultimately Tamoxifen. I'm a little nervous about not having chemo especially at my age. I just hope I can make peacewith this decision.

  • goldie63
    goldie63 Member Posts: 117
    edited November 2016

    My thought is just that you should do what feels right for you. I had BC in 1997 when I was 33 (hopefully the 1 and only time! Going thru a few tests right now). My oncologist said at that time that he was always going to recommend chemo based on my age, but when tests came back with a positive lymph node he put me on the more aggressive regimen. I was also PR-. ER- too. (no HER2 testing in those years. No mamma print or oncotype either, don't know what all that is.). Anyway he put me on CEF instead of CMF due to the positive lymph node. CEF seems to be the Canadian standard, then and now, compared to AC or CAF (FAC?) in the States. The efficacy seems to be the same but the E (epirubicin) is less heart toxic than the A drug. (The CF drugs are the same.). Check the topic Adrimycin vs Epirubicin on this site. I scanned just the first couple posts but it might be informative. If heart toxicity is an issue is CEF an option to discuss with your oncologist? I don't know how things work in the States vs Canada but figured you might find this topic informative. I hope all goes well for you.

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