Statistics - recurrence

Kailahi

Aloha!

I'd appreciate any links to studies about Tamoxifen and AI's.  I've done some research but don't always remember to bookmark them.    I think I saw I have something like a 65%?? chance of being around in 10 years if I don't have hormonal therapy.   My Oncotype DX test (16) said I have a 90% chance of being around in 10 years without distant recurrence with tamoxifen and I've read AI's make that a 93% chance.    It seems most studies I've seen compare tam & AI's.   I can't remember any that also includes statistics for no hormonal therapy but they must be out there!    

I'd like links because an alternative MD I've consulted with doesn't believe those statistics and wants to see studies.  I only had a lumpectomy when I first had breast cancer stage 1 in 2004.  I opted out of everything else.   At that time there was a calculator on Mayo Clinic which said I had a 90% chance of being around in 10 years with no adjunctive therapy (did not give a statistic for recurrence though and I knew it was higher) and 93% of being around with adjunctive therapy.

 This time I had a bi-lateral mastectomy (started with a lumpectomy, the mammogram & ultrasound only "saw" .10 cm and the tumor was 2.5 cm - so I wanted both breasts gone!).   I'm still trying to decide on tamoxifen or AI (that my onc recommends.)   Onc & primary did not suggest I get estrogen tests ... but I managed to get them ordered.   The urine test shows me very very low in estrogens.   Waiting for estrogen saliva & blood test results.   If my estrogen tests all agree, I doubt I will try AI's.   I would then look at tamoxifen but would want to take whatever test it is that determines if it will be helpful.      I am 70.  

I also posted this on another forum.

I have gone the alternative route as much as possible so far.    I have 2 alternative MD's I consult with plus recently had several appointments with a Naturopath. 

Mahalo for any clarification!

konakat

Hi Kailahi,

Tamox is no longer used for post-menopausal ER+ women because tamox treats circulating estrogen which is high for pre-meno women and very low for post meno women (like your tests showed).  What post-meno ER+ women need to take into account is the estrogen produced in the tissues.  Androgen (found in muscles, and other places) is converted by the enzyme aromatase into estrogen.  AIs attack this source of estrogen.

 I found info on estrogen and post-meno women in this article http://www.medscape.com/viewarticle/573361 "Although levels of circulating estradiol are about 10-fold lower in postmenopausal women than in premenopausal women, tissue estradiol levels are elevated due to conversion of weak androgens to estrogens via the aromatase enzyme,and are sufficient to support the growth of hormone-sensitive tumors".

If your tests only took into account circulating estrogen, they may have missed this other source. This might be something that you should ask your doctor.  I have a feeling that AIs may be the way to go for you.

BTW -- I LOVE Hawaii!!!!! 

Elizabeth