Chemo prevention for ALH

SharonRose2017

I have not posted here very much because my diagnosis is atypical lobular hyperplasia, and I respect the fact that this is primarily a breast cancer forum. My best to all of you who generously share your experience and knowledge.

I was diagnosed with ALH in June after a vacuum assisted biopsy for calcifications on mammogram, and then had an excisional biopsy August 17 where the results were all benign.

Will summarize my dilemma. I also have “severe osteoporosis" as my lowest T score is -3.4 femoral neck.

I saw a rheumatologist after the medical breast specialist said I should see one before any chemo prevention decisions are made.

After lab work, breast MD and rheumatologist said I should take Prolia (very expensive) or Reclast, not quite so bad per my Part D.

In the meantime I researched and saw the potential for problems with dental work. My dentist did reassure me and said he has methods of prevention and being proactive, and is very used to patients who take Reclast or whatever.

Then I told the breast MD that I was concerned about osteonecrosis of the jaw because I have an extensive dental history. And I asked about how Reclast was going to treat my breast cancer risk.

Today the response was she would recommend Evista with my concerns. I'm kind of getting whiplash with all the confusing recommendations so far!

I am getting a second rheumatologist opinion January 30 at a different hospital system in our city. Question is, should I go on Evista in the meantime to see if I get any side effects BEFORE I see the second MD?

Obviously, I don't even want to do anything until after Christmas because of any Evista side effects.

Any input here is so very welcome! I know it's the holiday, but I probably won't even hear from the MD until after January 2 anyway. Bad timing!

Thank you for this forum and for providing a place for non cancer diagnosed people to seek info!

momoschki

Sharon, I can’t speak to the confusing and conflicting recommendations, but I can share my own experience. My situation is somewhat comparable, with a dx of ADH and some osteopenia. I have been taking Evista for a little over 3 years now- no real side effects with the exception of some (tolerable) hot flashes, which I had before taking it anyway. It seems to me that waiting another month until after your upcoming appt won’t really matter in the long run, and ‘besides, side effects can sometimes take several months to surface. I think the Evista can be a good choice as it kills 2 birds with one stone: the bone density issues and breast cancer prevention

SharonRose2017

Momoschki, Thank you so much for your thoughtful and very helpful reply. I am more concerned about the high risk for breast cancer than the osteoporosis, and I felt the former was being side tracked in this avalanche of medication recommendations. I am hoping for more clarity after the second opinion. I wish you continued health and happiness in the new year.