Abstract: ObjectiveTo investigate the adverse reactions and the efficacy of adriamycin+cyclophosphamide+docetaxel （ACT） sequential chemotherapy and docetaxel+adriamycin+cyclophosphamide （TAC） combined chemotherapy in postoperative treatment of breast cancer. 
MethodsFrom February 2012 to September 2013， 130 postoperative breast cancer patients were randomly divided into observation group and control group with 65 cases in each group. Control group was treated with TAC combined chemotherapy： cyclophosphamide iv 500 mg／m2d1， adriamycin iv 50 mg／m2 d1， docetaxel 100 mg／m2 iv d1. Twentyone days was a cycle and 6 cycles was given. Observation group was given ACT sequential chemotherapy： cyclophosphamide 500 mg／m2 iv d1， adriamycin 50 mg／m2 iv d1. Twentyone days was a cycle and 4 cycles was given. And then docetaxel 100 mg／m2 iv d1was given with 21days as a cycle for 4 cycles. Adverse reactions and lymph node metastasis were recorded， and the dieasefree survival time（DFS） of the two groups was followed up. The level of serum angiopoietin 2 （ANG2）， vascular endothelial growth factor （VEGF） and nm23H1 protein were tested. 
ResultsAfter treatment， the levels of ANG2 and VEGF in observation group were significantly lower than those in control group［（341±39） ng／L vs. （581±36） ng／L； （518±43） ng／L vs. （817±44） ng／L］， while the level of nm23H1 protein was significantly higher than that in control group［（669±42） ng／m vs. （533±33） ng／ml］. The differences had statistical significance between the two groups （P＜005）. The main adverse reactions were in grade 12. The incidence of leukopenia， neutropenia， nausea， vomiting， oral mucositis and hepatic dysfunction in observation group were lower than those in control group （P＜005）. The number of lymph node metastasis in observation group was significantly lower than that in control group （P＜005）. The occurrence time of lymph node metastasis in observation group was longer than that in control group （P＜005）. The median DFS was 424 months in observation group， longer than 346 months in control group （P＜005）. 
ConclusionThe long term efficacy of ACT sequential chemotherapy is superior to TAC combined chemotherapy for postoperative breast cancer patients， which shows fewer adverse reactions and can effectively inhibit the lymph node metastasis of breast cancer. therefore it is worthy of clinical promotion.

Key words: Breast cancer, Adverse reactions, Lymph node metastasis, Angiopoietin 2 （ANG2）, Vascular endothelial growth factor （VEGF）, nm23H1