IDC +ER, +PR and her2 neg chemo regimen

I'm also ER/PR+,HER2- I'm 38, premenopausal but already have children. Not sure how much of role that plays in differences of treatment.

My treatment regimen will be the first scenario you have listed. 4 dose dense AC, then 12 weekly T. I haven't researched much yet regarding options for what comes after the initial chemo. My MO has planned the usual 5yrs of Tamoxifen.

I will also be getting Neulasta with the AC although I didn't know about that part of the plan until today so that could be part of your option 1 as well. They'll be giving me some prophylactic anti-nausea medicine - Zofran. And they're also having me take a weird little OTC cocktail to help with the bone pain associated with Neulasta: Benadryl,Claritin, and Zantac.

I had a port placed when I had my mastectomy on the 8th. It's a weird feeling having it there. However, I was immensely bothered by the idea of having to get the "sturdier" iv line each time so I opted for the port. I have an older cousin that said the chemo was really rough on her veins (20yrs ago and doesn't know what kind) and wishes she had gotten a port.

I agree it would be a lot more reassuring if there was a solid consensus that says Xcancer = Ytreatment standard.

Here's another link regarding ovarian suppression: https://www.medscape.com/viewarticle/859195#vp_2

And an excerpt:

Beverley Moy, MD, clinical director at the Massachusetts General Hospital Cancer Center, in Boston, told Medscape Medical News that the breast cancer community had been waiting for years to hear these data on whether there was an extra benefit from ovarian suppression.

Commenting last year on the results from the SOFT and TEXT studies, she said that there was no significant benefit in the overall study population but that a significant difference was seen in the population of women who were premenopausal after chemotherapy. These women tended to be younger and have more aggressive disease, she said. In absolute terms, these women, after 5 years, had 7.7% fewer breast cancer events with exemestane and ovarian suppression compared with women receiving tamoxifen alone.

"I do think the data are practice changing in this subset of patients," Dr Moy told Medscape Medical News. "However, you have to temper that benefit with the fact that the combination had significantly more side effects. Making premenopausal women abruptly menopausal can lead to many side effects — hot flashes, sexual dysfunction, depression...and also joint pain and potentially osteoporosis with the aromatase inhibitor.

"You have to weigh the risks against the benefits," she said. "It's a difficult clinical situation that we face. These are young women with aggressive disease, and I'm delighted that we have found a treatment option that provides benefit, but it comes at a cost."

LHerbs - I'm starting a total of 8 chemo cycles on Feb 9th 2018. 4 cycles of AC first followed by 4 cycles of T - every other week. With neulasta after each session to boost my immune system. After that, tamoxifen. I just turned 41.

hi, it seems like we have very similar stats. I am on AC+T regimen. Dose dense 4xac and 4xtaxol.

I did get a port in my arm. My mo said the scar would be less disfiguring...

I just got my first round this Thursday. So far so good, I think the steroids are giving me lots of energ

Hi LHebs,

Looks like I had the same diagnosis as yourself through a biopsy. I was given 12 weeks of Taxol and then 4 rounds of AC. Originally my tumour was 2.2 cm with 2 lymph nodes involved. My Allred for both ER and PR were 8 - the highest. After my mastectomy and axilla lymph node removal my pathologhy report showed only partial response for my tumour (1.6 cm) and NO response for the lymph nodes. Infact more cancer was found in the lymph nodes and in the vascular system around the lymph nodes.

After this I researched and found out that the neoadjuvant chemo is really not effective on hormone positive breast cancer. If I had to do it all over again I skip right to surgery.

Do you have your allred score? This score tells you if your cancer is very hormone sensitive. It might be helpful to ask what they are hoping to see happen for you after chemo - tumour shrinkage, breast conserving surgery? I did not know that hormone positive breast cancer does not respond well to the chemo - hormone therapy is more effective.

Just thought I would let you know my story with chemo. I wish my MO had told me that my cancer was not a good candidate for this treatment. Many months of treatment for not much in return.

I’m not sure I have much to say to help but just wanted to note that I’m struggling with the AI/OS v. Tamoxifen decision myself. (34 y/o, stage 1A IDC, ER/PR+/her2-, oncotype 16, no chemo). First opinion recommended AI/OS, almost as if it were the only option due to my age. Second opinion recommended 10 years of Tamoxifen and didn’t even raise AI/OS until I asked. Not sure the reduction of a few percentage points is worth the side effects and lifestyle impact to me but feel kind of “lazy” or “weak” not doing everything possible.