TC

Say it: tee-SEE

Docetaxel and cyclophosphamide

TC is a two medicine chemotherapy given every 3 weeks to lower the chance that early stage breast cancer comes back.

Also called: TC chemo, DC, docetaxel cyclophosphamide, Taxotere Cytoxan, TC x 4, TC x 6

What it is

Docetaxel and cyclophosphamide kill cancer cells in different ways. TC avoids anthracyclines (such as doxorubicin), which can be easier on the heart. It is often used after surgery to kill any cancer cells that may have spread, with the goal of cure.

Often used for

• early stage breast cancer after surgery
• early stage breast cancer before surgery (less often)
• HER2 negative breast cancer that has a higher chance of coming back

4 cycles or 6 cycles

Most people get 4 cycles. Some with higher risk cancer get 6 cycles.

The medicines in this plan

Docetaxel

Taxane chemotherapy that stops cancer cells from dividing. Given through a vein over about 1 hour on day 1.

Cyclophosphamide

Chemotherapy that damages cancer cell DNA. Given through a vein over 30 to 60 minutes on day 1.

Pegfilgrastim

White blood cell booster given as a shot the day after chemotherapy, or by an on-body injector placed on day 1, to lower infection risk.

How you get it

TC is given in an outpatient infusion clinic every 21 days. A treatment day usually takes 2 to 3 hours. Most people get 4 cycles, which takes about 3 months. You take steroid pills (dexamethasone) before and after each treatment to prevent reactions and fluid buildup. Your schedule may be different.

A typical cycle

Day before

Start dexamethasone pills, usually for 3 days (the day before, day of and day after treatment).

Day 1

Blood tests, then IV docetaxel and cyclophosphamide. An on-body injector for pegfilgrastim may be placed.

Day 2

Pegfilgrastim shot or injector goes off. Bone aches can start.

Days 3 to 10

Tiredness, body aches and nausea are most likely. Blood counts are lowest around days 7 to 10.

Days 11 to 21

Recovery. Visit and blood tests before the next cycle.

Common side effects and what helps

• Hair loss, usually 2 to 3 weeks after the first treatment. Ask about scalp cooling, which may reduce it.
• Tiredness. Gentle exercise such as walking helps.
• Low white blood cell counts. Wash hands often and avoid sick people.
• Bone or muscle aches from pegfilgrastim and docetaxel. Ask your team which pain reliever to use.
• Nausea. Take your anti-nausea medicines as prescribed.
• Nail changes or darkening. Keep nails short and clean; some people use frozen gloves during the infusion.
• Fluid buildup and swelling in the legs. Take every steroid dose and tell your team about sudden weight gain.
• Tingling in fingers and toes. Tell your team if it gets worse.
• Watery eyes, mouth sores or taste changes. Rinse your mouth often with a mild salt and baking soda rinse.

Call your care team right away if you have

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• Trouble breathing, flushing, chest tightness or rash during or soon after the infusion
• New shortness of breath or cough
• Sudden swelling or weight gain of more than 5 pounds in a week
• Vomiting or diarrhea that will not stop, or you cannot keep fluids down
• Pain, redness or pus around a nail
• Blood in the urine

Good to know

• You will have blood tests before each cycle.
• Taking dexamethasone exactly as prescribed is important to prevent allergic reactions and fluid buildup from docetaxel.
• Infection risk is highest about a week after each treatment, which is why the white blood cell booster is given.
• Chemotherapy can affect fertility and periods. If you want children in the future, ask about fertility options before starting.
• Do not get pregnant during treatment; use birth control that your team approves.

At home

• Take your dexamethasone pills on the right days; set phone alarms.
• Keep a thermometer at home and check your temperature if you feel unwell.
• Drink plenty of fluids and keep moving to help with swelling and constipation.
• Use a soft toothbrush and moisturize hands and feet daily.
• Ask about an over the counter allergy pill (loratadine) for booster shot bone pain.

Questions to ask

• Will I get 4 or 6 cycles?
• Can I use scalp cooling to save some of my hair?
• How much does chemotherapy lower my chance of the cancer coming back?
• What other treatment (radiation or hormone pills) will I have after TC?
• How will this affect my fertility or periods?

Breast cancer

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.