AC and CMF are the most commonly used combinations for the adjuvant treatment of breast cancer. If the patient is node positive, the physician may give four cycles of AC followed by four more cycles of treatment with paclitaxel. Metastatic breast cancer patients may receive any of the combination therapy mentioned above. Most commonly used single agent chemotherapy drugs in the treatment of metastatic breast cancer include, docetaxel, venorelbine, gemcitabine, and paclitaxel. Her2/neu positive breast cancer patients may benefit from a combination of chemotherapy with monoclonal antibody herceptin. A combination of carboplatin and paclitaxel with herceptin has recently shown to improve
survival in patients with Her2/neu positive metastatic breast cancer. A recent study has found that administration of 4 cycles of adriamycin and cyclophosphamide (AC) given every two weeks is better than given every three weeks. Another study has suggested benefit of adding docetaxel (taxotere) to the adjuvant regimen improves survival. This approach is known as dose-dense chemotherapy and could be associated with significantly low ANC. White cell growth factors like (filgrastim, pegfilgrastim) are usually given with this type of chemotherapy to minimize the problems associated with low ANC.