Thursday, August 21, 2008

Breast Cancer: weekly taxol vs. tri weekly tch?

Question posted in Breast Cancer Forum:

I'm very concerned over the 2 different paths of treatment proposed to me by 2 different oncologists. Onc #1 proposes a 12 week regimen of taxol administered weekly adding herceptin later then followed by tamoxafin, while onc #2 suggests taxotere, carboplatin, herceptin every 3 weeks for 6 cycles then followed by tamoxafin. Not sure who to go with.
I had an excisional biposy done for a breast tumor that measured 4 x 4 x 1 and during a pet scan a vauge area on my liver approx 2.1 x 1.8 in size which onc #1 believes metastasis has occured and will not order a liver mri while onc #2 wants a liver mri to confirm but believes that metastasis is definitely possible. My tumor is her 2 positive and estrogen sensitive.
Because of my age of 27 they both believe that aggressive treatment is necessary. I just don't want to make a fatal mistake. What are the + / - of either treatment and why are the 2 onc on different pages?

Reply from the Cleveland Clinic:

There is no absolute correct way to approach breast cancer treatment. Certain factors about the tumor may help to direct aspects of therapy, such as whether the tumor is HER2 positive or Estrogen and Progesterone receptor positivity, but these do not dictate the exact treatment regimen. An MRI may or may not clarify the appearance of the liver lesion (it may increase or decrease suspicion) but it will not be absolute. The only way to know for certain is to biopsy and this may or may not be advised depending on your situation. Without evaluation, we cannot determine what regimen we would recommend. If you are not comfortable with either option, consider a third opinion, preferably with an oncologist who specializes in breast cancer. These are often affiliated with large academic medical centers.




Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.

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