[Becky]

There is another tumor test you can use to determine if you should take AC followed by TH or TCH. That test is the Topo 2A test. In about one third of Her2+ cases, Topo 2A is also overexpressed (because this gene lies very close to the Her2 gene on the chromosome). It has been noted that adriamycin (the A in the AC part) works very well at "killing" cancer cells that are Topo 2A positive. However, regardless of pathology testing, many, many studies corelation results that show that either chemo regime works very well against the disease. In Europe, they use a much wider variety of chemo drugs and as long as Herceptin is also used (if Her2+) the outcome is better. So really, getting the Herceptin is key.

Other things to consider is that adriamycin is hard on the heart and Herceptin can be hard on the heart (for 4% of the people who receive it) so that regime may give a double whammy if you have heart problems to begin with. Secondly, when they compared women who got AC followed by TH vs TCH, there was also a notable % (can't remember the % exactly but I know it is between 1% - 4%) get acquired leukemia from the chemo with the AC regime but no cases in the TCH regime. That is another consideration and question to ask.

Don't worry about the oncotype dx testing. They are not really sure how it fits in with Her2+ or triple negatives as it is more aggressive cancer BUT that's what chemo kills best and Herceptin works great. My pathology is alot like yours - 1.9 cm tumor but POSITIVE nodes and I am here and fine almost 4 1/2 yrs out. You will be fine.

Stay tuned with us and we will answer your questions as you go through this journey if you need us.

PS - you will lose your hair with either chemo plan unfortunately.