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Adriamycin improves survival 2.5%. Is it worth it?

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dono7392 View Drop Down
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    Posted: Nov 24 2019 at 5:19pm
I was diagnosed with TNBC (2 cm, Gr. 3, no lymph nodes, very aggressive) and had a bilateral mastectomy (as opposed to a lumpectomy, which I now regret). Based on my cancer, Adriamycin is said to improve my chance of survival by 2.5%. I'm not sure that's worth it given the risks associated with the drug. In my area, the "standard of care" is AC-T though my doctor said I can decline the "A." Any thoughts?
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Post Options Post Options   Thanks (1) Thanks(1)   Quote strongtogether Quote  Post ReplyReply Direct Link To This Post Posted: Nov 24 2019 at 9:51pm
I am surprised that they would suggest that you drop the Adriamycin. It's a mainstay of your treatment. 
Do you have any underlying health issues? I would say that you should hit it as hard as you can.
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123Donna View Drop Down
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Post Options Post Options   Thanks (1) Thanks(1)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Nov 24 2019 at 11:30pm
What your doctor is recommending is the standard of care.  I guess the question I'd ask myself would be if I declined Adriamycin and I recurred, would I regret my decision?  In all honesty, no one knows who will recur and who won't.  I wish we did.  If they could predict it, then some women could skip further treatment.  We only get one chance to fight this beast the first time.  Could a second opinion help you decide?

PS:  If you look at my stats, you'll see I had T/C the first time.  Only later would I learn that those cells had already escaped the tumor at time of diagnosis and were too small to be seen on the MRI.  I wonder if I had the "A" the first time, would have I recurred?  I came to learn 95 to 96% of tumors drain to the sentinel nodes, but not all.  A small percentage like mine, drained elsewhere.  So all of my sentinel nodes were clear, clear margins, stage 1 tumor, bilateral mastectomy, etc.


DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote dono7392 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 26 2019 at 11:16am
Thank you for your replies. My oncologist is not recommending it but will allow it if I decline. I have a congenital heart defect and family history (including my brother) of early death due to heart issues....so I am concerned. But also concerned about cancer metastasis if I don't go on effective chemo......
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dono7392 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 26 2019 at 11:21am
I mean he's not recommending that I drop A but will let me decline it.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Nov 29 2019 at 9:50am
Do you see a heart specialist?  If so, ask their opinion and if there are any ways to reduce  future risk of heart problems from Adriamycin.
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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dono7392 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dono7392 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 29 2019 at 10:48am
Thank you for sharing your story 123Donna. You are correct that we just don't know what if any cells have escaped and will cause future issues. I'm not sure I have a choice now -- a second opinion also suggested ACT and also Herceptin as we just learned there is a small percentile of Her2+ cells.
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Post Options Post Options   Thanks (1) Thanks(1)   Quote Kellyless Quote  Post ReplyReply Direct Link To This Post Posted: Nov 29 2019 at 5:55pm
Remember what that 2.5% less survival means - 2 and a half people out of a 100 that skip the AC die. With our disease it's not usually "eventually", "very agressive" means FAST, so 2 1/2 women are gone within a relatively short amount of time after declining it. Thinking about exactly what  that really represents helped me make the hard choices. Thinking about what that would mean to my family, that's what seals it for me. 
IDC, 2.2 cm, Stage IIb,lumpectomy 1/30/09 ACx4,Tx4 36 rads
6/1/16 Local recurrence same breast, same spot 1.8cm Carb.4x every 3 wks, Taxol 12x once wk. Dbl Mast. PCR!! Reconstruction fail, NED!
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Post Options Post Options   Thanks (1) Thanks(1)   Quote Tamara Quote  Post ReplyReply Direct Link To This Post Posted: Dec 01 2019 at 4:42pm
I did AC-T, a close family member did not. She and I went through treatment at the same time. We are 5 years out and she is facing bone mets now. In no way am I saying she wouldn’t be facing bone mets if she had opted for AC-T as we each made our decision based on our own circumstances but it is something to think about
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