New Chemo

Allison

Glad you found us; sorry you have to be here. 

AC-T (either dose dense AC-T or dose dense AC- 12 weekly Taxol or TAC (where T is Taxotere)) combinations are the standard of care for high risk BC, including TNBC).  There are limited studies indicating that cisplatin may benefit patients with BRCA mutations but how that extrapolates to the non BRCA population is unknown at this point.  There are trials involving cisplatin but as your docs say they are generally in the neoadjuvant setting (chemo before surgery).  There is the Hoosier Oncology cisplatin/rucaparib adjuvant trial for TN patients who did not get a pathological complete response again for patients who had neoadjuvant chemotherapy.  I am not aware of any trial that would add on additional adjuvant therapy in the absence of evidence of ineffective chemotherapy (because your tumor was surgically excised, there is no way to tell if the ACT will work or not – in the adjuvant setting, the chemo is presumably targeting micromets, not detectable by standard methods).

Your docs are correct regarding the survival stats on mastectomy vs lumpectomy with radiation, in general, although lumpectomy with rads may have a slightly higher local recurrence rate.

If I were in your position, I would focus on getting through the chemo and taking care of yourself.  Basically, there are no good data that can predict who will or won’t respond to ACT.  A number of ladies here who received neoadjuvant ACT did achieve complete pathological response, which is to say, their prognosis is much improved.