Anecdotally, it seems like there may be some differences between common practices in different countries (?).
Here in the U.S., the National Institutes of Health sponsored a breast cancer consensus development conference last November. This is a forum where experts come together & issue a consensus statement about treatment for some health problem.
In the breast cancer consensus statement, one passage reads:
"Randomized trials have demonstrated threshold dose effects for two of the most active chemotherapeutic agents, doxorubicin (A) and cyclophosphamide (C). These two drugs are frequently administered together (AC) and appear to result in a comparable survival outcome, whether given preoperatively or postoperatively. However, AC has not been compared to cyclophosphamide/doxorubicin/5-fluorouracil (CAF) or cyclophosphamide/epirubicin/5-fluorouracil (CEF)."
and another:
"At the present time, there are no convincing data to support the use of any known biological factor in selecting a specific adjuvant chemotherapy regimen in breast cancer."
I'm taking these quotes somewhat out of context, but I don't think doing so grossly misrepresents what the report has to say about Kaye's specific question.
The whole report can be found at: http://consensus.nih.gov - look for the breast cancer link toward the middle of the page. I found the consensus statement helpful & interesting, and also found some good information in sources referenced in its bibliography.


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