Newly diagnosed

Ellence (Epirubicin) is an anthracycline, much like adriamycin. To my knowledge, they have never been trialed against each other to see which is better. Like adriamycin, epirubicin has usually been used in combination with cytoxan/cyclophosphamide or cyclophosphamide and 5-FU. Ellence does have a better cardiotoxicity profile than adriamycin, and for that reason is the anthracycline of choice in Europe. I found it o.k., although constipating and hard on the veins. However, because it is easier on the heart, if it turns out to be as effective, in may have advantages for herceptin-based chemo.

I guess my main concern about the trial options that have been suggested for your wife is that it was herceptin-based chemo rather than herceptin following chemo that had the big payoff in the most recently announced clinical trials. Whereas AC followed by taxol followed by one year herceptin reduced recurrence by 13%, AC followed by (taxol+herceptin) followed by one year herceptin reduced recurrence by over 50%. That's a really big difference in outcomes. And the nice thing about the trial was that it seemed to have really dramatic reductions even when there were lots of nodes involved.

I'm a bit surprised that your oncologist hasn't recommended the trial combination or some other herceptin-based chemo, since this was hailed as one of the greatest breakthroughs in early breast cancer treatment ever at last May's ASCO.