Anyone have neoadjuvant AND adjuvant chemo?

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livebig
livebig Member Posts: 86
edited June 2017 in HER2+ (Positive) Breast Cancer

Long story short I am a stage 3/stage 4 limbo (liver biopsy of mass was negative, but onc still questions metastasis).

I had 6 rounds of TCHP. Double mastectomy 2 weeks ago and the pathology report showed complete pathological response to neoadjuvant chemo.

Oncologist is recommending 4 rounds of AC. Is there anyone who had a complete response and still did more chemo following BMX? Thanks

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  • stephincanada
    stephincanada Member Posts: 228
    edited June 2017

    Hi Livebig,

    Although I can't answer your question directly, I can give you my perspective, for what it's worth. The "A" in "AC" is adriamycin, which is an anthracycline. In Dennis Slamon's 3,222 person trial comparing AC-TH to TCH, there was a 3% survival advantage to taking the anthracycline. It was recommended that I take the anthracycline. There is a tiny risk of leukaemia (.25%) and heart failure. I figured that I get one chance to slay the HER2 beast for good, and I may as well give it everything I can.

    "For tumors measuring 2 cm or more at diagnosis, the 5-year rates of disease-free survival were 82% in the group receiving AC-T plus trastuzumab and 79% in the group receiving TCH".

    http://www.nejm.org/doi/full/10.1056/NEJMoa0910383...

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  • livebig
    livebig Member Posts: 86
    edited June 2017

    thanks Stephanie

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited June 2017

    liveBig - Yes - sort of. I had already had a BMX for DCIS with no other treatment. Then two years later I had a "local recurrence" in a lymph node - now it's IDC, ER/PR negative, HER2+

    Treated with neo-adjuvant TCHP. And did NOT have pCR. The ALND surgery got clean margins, but my MO still wanted me to do 4 rounds of AC. Then rads & back to Herceptin for a year.

    It was not fun, but doable. Good luck with your choice.

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  • Kat1984
    Kat1984 Member Posts: 47
    edited June 2017

    hiya,

    Whilst my diagnosis does differ from yours (I was stage 2a triple negative), I did have chemo both before and after mastectomy.

    I had 4 rounds of AC then mastectomy, we found out then I had a complete response to the AC. I then questioned why I needed to have 12 weekly Taxols but my MO said my treatment plan remains the same regardless of response.

    So after the pCR and I'd healed from surgery I had 12 taxols. Because of the complete response prior I did manage to avoid radiation afterwards though. I hated that the chemo was dragged out longer (had a 2 month break for surgery between last AC and first taxol) but ultimately I feel like the taxol was my 'insurance'. I finished up just over a year ago and am doing well.

    Best of luck with the rest of your treatment

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