Why Fec and Fec-T???

just thought i’d ask the question as im getting stressed over the fact aarrgghh.

i had grade 3 cancer no node involvment and im having Fec75 x 6, other people are having Fec-t or tax/Tac with the same DX, i know that tax/Tac is a stronger chemo and hospitals are all different but am a bit worried the ONCS aren’t throwing everything at me??

anymore thoughts??

Tax s usually when nodes are involved chick x

i thought that hun but spoke to lots of people and they didnt have nodes involved and their still having Fec-t xxx

seems like its the ONC preferences but if you are worried I would certainly encourage you to ask and not sit and worry over it. Worrying is so draining I know.

Hopefully one of the experts will come along shortly and answer your concerns

Hi PinkPrincess81

I too am grade 3 no node involvement and ime on 6xFec90
mine isnt hormone related and ime triple negative so ive been told i wont be having any more treatment when Fec finished .
is yours hormone or are you triple neg as well princess
speak soon

I asked my onc that same question when he said he was giving me x6 FEC. I was worried about it but he said i didn’t need FEC-T & why give me 2 different regimes with 2 lots of side effects when he didn’t need to. I’m grade 3, IDC, ER/PR positive with micromets in 2 nodes. I still don’t really know the difference though so would be quite interested to find out.

its so confusing isn’t it, i know they sit in a board meeting to discuss who has what but i would rather know what drug does what…am i getting the right one…am i having more than i need…or why not have the same chemo for the same DX so confusing.

my understanding of it all was Fec-t was with lymph node involement but thats not the case as spoke to 4 people last few days and its all different, just want to know they have thrown everything at me as feeling scared about it coming back and haunting me :frowning: xxxx

italia03, yes im her2 so have to have hercepin for 12 months after chemo :frowning: xxxx


Mine was grade 3 no node involvement, ER+ and HER2+…ill be having FEC100 X 3 and docetaxel x 3, rads plus herceptin and tamoxifen. Not started it yet, my start date is 10th Jan , eeeeek!



I think a combination of factors are taken into consideration,size of tumour, node involvement, hormone status, age, does tumour have its own blood supply.

I am grade 3, no nodes, no vascular invasion, er & pr positive & had fec 100 x 6.



There are guidelines for the use of chemo in primary breast cancer on the NICE website which you can check out.

I was diagnosed with stage 4 from the start after a routine breast scan in June. Tiny tumour which had already spread to liver, lung and spine. I had FEC x3 followed by TAX x3. My understanding is that TAX is generally used when the BC has spread to other areas. Having had both, I’d say that TAX isn’t something you want to have unless you really need it!

Good luck with your treatment.

Laurie x

It does seem each Onc has a different approach doesn’t it? Hmm! very confusing.

I’m stage 3, grade 3, triple negative, 5cms lump, no nodes. My planned regimen was 3xEC and 3xTax, after 2xEC I was changed to 4xTax because my lump hadn’t shown signs of shrinking, after 2xTax lump had shrunk to 3.8cms, had 3rd Tax 22nd Dec, 4th is 12th Jan - hoping Tax does it’s job and shrinks lump to size of a pea.

Hi Pink Princess 81

This was a topic that was discussed a couple of months back and I have posted the reply that Sam, BCC gave us which should help answer your question. As she says, the best person to discuss why you are being given your particular treatment regime is your oncologist.

Sam BCC says on 29 Nov 2011 15:53
I am making this post on behalf of the clinical team:-

Hi everyone,

With regard to ‘libsue’s query about why some people are put on EC or FEC for three cycles and then Docetaxol for three, and what the advantages are of using both prescriptions.

You’ll all know that chemotherapy is a treatment using anti-cancer drugs. Their aim is to destroy breast cancer cells. It’s known as systemic treatment because the whole body is exposed to drugs. Various factors are taken into consideration when deciding on whether or not to recommend chemotherapy in the first place and if chemotherapy is recommended which type of drugs would be best to use. These factors include, for example, the size of your breast cancer, the grade and whether the lymph nodes under the arm are affected. Also your general medical health and any other medical conditions will also be considered.

There are many different types of chemotherapy drugs used to treat breast cancer. They can be given in different ways and also in different combinations, according to your particular situation.

The way chemotherapy works is that it interferes with the way cancer cells grow and divide (the cell cycle). Using different chemotherapy drugs in combination will interfere with the cell cycle at different phases of its growth.

That is why a combination of drugs is used.

The NICE (National Institute for Health and Clinical excellence) guidelines recommend that chemotherapy after surgery for breast cancer should consist of 4-8 cycles of a combination of drugs, including an anthracycline (epirubicin or doxorubicin). NICE have also approved docetaxol (Taxotere) after surgery for women with early stage breast cancer who have lymphnodes under the arm that contain cancer cells. In 2009, a review of chemotherapy trials for early breast cancer found that adding a taxane based chemotherapy regime to anthracycline chemotherapy seems to reduce the risk of the cancer coming back more than using anthracyclines alone.

It’s important to remember that everyone’s cancer is individual to them, and therefore treatments will vary. Oncologists will weigh up the benefit (or additional benefit of different drugs) of chemotherapy versus the side effects before making any of their recommendations.

Do talk to your specialist team if you are unsure about the combination of chemotherapy drugs that you’ve been offered.

Best wishes Sam, BCC Facilitator

and why have most (as it seems) people FEC and some EC?

I’m grade 2, stage 3 A (due to size 5 x 7.5cm and node involvment), ER+, HER2 +++ and have 3x FEC and 3x Docetaxol, 1 year Herceptin and 5 years (I don’t know where they get their optimism from!!!) Tamoxifen

thanks for the comments :wink: xxx

Many people have asked these questions before and we never seem to get totally clear answers. But factors that are considered are the usual- grade, size, status etc but also included are

Onc preference- some doubt the usefulness of the F of fec and are concerned it can effect the heart so don’t give it.

Age at dx, I was given fec t when I asked if the it was because I had a node involved I was told that it was because I was young ( 38)

Some chemos appear to work better with some cancers.

They do not want to over treat and give long term problems to people if a less harsh chemo has a similar benefit.

In some cases there is a higher chance of recurrence and they want to hold back a chemo ( I don’t think this happens often)

Herceptin works alongside some chemos but not others due to heart probs.

Fitness and pre existing conditions

Whether you have surgery first or after.

But I do know of people who have done their research and asked for a different chemo than the one suggested. They have argued for it and got it. It is ok to ask your team specifically why that one has been chosen for you. There are probably many more variables than the ones I have mentioned. I have been told that oncs consult with each other and discuss cases and see if they are on treatment plans. Mine told me that even at my age at dx and with a node involved many oncs would still ave given me just fec as it is a tried and tested chemo. Sorry it is so confusing.



I was diagnosed 8 years ago, primary, grade 1/2, 6/17 nodes involved, ER+ and had 6 FEC. I remember that this was usual at the time.


Midge said


Let’s check the glossary and info on BCC site :slight_smile:

FEC leaflet produced by BCC:
Quote from page 2: “FEC is a combination of three chemotherapy drugs: 5-fluorouracil (also known as 5FU), epirubicin and cyclophosphamide. FEC takes its name from the initials of these drugs”
It is epirubicin which can affect the heart muscle,

At my hospital, some primary bc patients get 6xFEC after surgery, as happened to a local friend of mine who was dx a few weeks before mine. I was dx with mets 3 weeks after primary, so my treatment was different - my first chemo was 6xEC, then a year later, paclitaxel (Taxol) which didn’t work for me :frowning:

I’m now getting the “F” of FEC - capecitabine is converted into 5FU in the body, mainly by the cancer cells (!)

Hi, I was also told that the fluoracil can have cardio toxic side effects. If you look up 5FU on the Macmillan website chemotherapy section they have a fact sheet on side effects including the effects on heart function. I had 2 Fec and 2 docetaxel & cyclophosphamide (no nodes) but multifocal and this was the decider for my onc on the tax, didn’t have 6 as I had allergic reactions and was assured 4 cycles was enough.


Princess, sorry to hijack your thread but as Mrs Blue has quoted me I will respond. I can only speak from my own experience, research and what my friends and our collective oncs have told us. My close friend was given EC x 6 and questioned why and the heart implications were cited. On further research on the Internet


There are other sites that suggest this also.
We discovered that it was a less common side effect. She was told that if he believed she needed it she would have it. As yet I have not heard of any other reasons why some people do not get the F, so until then I can only accept what I have been told. But perhaps I was wrong to share it as I am not an onc. I would always suggest, as I think I did, that you speak to your team about it.
Good luck with your treatment Mrs Blue. Happy New year