Premenopausal dilemma: OFS + Tam vs. OFS + Aromasin

UdiStrong

Hi Everyone,

Looking to get some input re side effects on the above treatment options. In short I'm young (dx at 34), I did have chemo and in a premenopausal state. I have already started Zoladex (with significant QOL side effects) and having to make the decision whether to start Tam or AI. Per the SOFT results OFS+AI conferring a 2% point benefit over OFS+Tam. I am weighing out the potential side effects and thinking that the Zoladex has already made a huge difference anyway (negatively). Wondering if it matters that much whether I go with Tam or AI. Leaning towards AI since it's slightly better statistically speaking.

I welcome any input from those with experience - many thanks!

exercise_guru

Udistrong I had an oophrectomy and could not tolerate the problems with arimidex and Femara so I am currently on Tamoxifen. I will probably go back and re-try an AI eventually because it is slightly better in my situation.

I have read (but I can't find the link) that for women around 35 years of age that AI cuts the risk from 1 in 3 to 1 in 6. I will see if I can find the link.

kcat2013

Udistrong, I was also 34 at diagnosis and am on Lupron for ovarian suppression + Tamoxifen. My MO felt T was a better choice for me for a few reasons, the most significant being the loss of bone density associated with AI's. I'm at risk for osteoporosis already and MO felt like an AI would not be a good choice for me.

LM070917

Hey, I was also 34 yrs old at diagnosis. Having read the benefit of the SOFT trial I decided to go with AL (Arimidex) and zoladex, esp as BC in younger women is supposed to be more aggressive. I wanted to do everything I could to reduce the risk of it coming back and the stats suggest that. My oncologist advised I also go on Zometa which is a 15 min infusion every 6 months whilst on AL to reduce bone loss and protect against bone mets. I don't think it matters whether you go on A or tax they all cause bone density issues. My AL side effects have been some bone aches, sexual dyfunction and hot flushes, but it's all subsided over time. I've been on Arimidex for 6 months now and pretty happy with it

KateB79

I'm doing Zoladex and tamoxifen together until I'm 40 (in 2.5 years), at which point my MO plans to "re-evaluate" and consider prescribing an AI. Her line of thinking is similar to what kcat said above, and also includes the fact that, in my MO's words, "tamoxifen has been around for a long time, and we know what to expect with it."

Cardiac, bone, and brain health are all on the list of positives for tamoxifen vs. an AI.

I will say that my WBCs have been a little low, so I might have to evaluate that AI sooner rather than later, but tamoxifen has been easy. Adding the Zoladex hasn't been fun (whoa! so many weird things!), but I'm told that some of those SEs level out over time. . . .