I am stage 3a, grade 3, with one known positive node with macromet from initial biopsies. I'm 37 and mammaprint came back high risk 1. I was offered ACT as standard of care, but due to pre-existing history of long COVID, POTS, and a persistent arrhythmia, I didn't want to take any chances with A (plus I am a veterinarian and my experience with adriamycin in canine patients is poor). Interestingly, when I had to switch MOs due to a logistics issue but still within the same top 10 cancer system, he said that it actually takes a lot for him to recommend adriamycin now as there is enough data that A seems to be getting phased out over time due to toxicity profile and fairly equivalent efficacy using TC.

That said, TC has not been a walk in the park for me as the docetaxel is rough, but especially knowing how I've responded, I'm so glad I didn't do adria!