Breast surgeon comments & my own pathology. Encouraging for you.

Lea7777

First my 2nd opinion breast surgeon's comments:

A few months ago she told me that in the short period between an invasive breast cancer diagnosis and surgery, she advocates endocrine therapy of some type for her patients. She was not specific on which of "the drugs" and I don't think it mattered. She said how pleased she has been at the reduction in tumor size in just a few short weeks of treatment. She said the tumors can shrink to half or even 10% of their size in a matter of a couple of weeks and this is not a rarity. She did not have stats (and not all tumors shrunk), but she just wanted to share that info with me regarding "the drugs."

My own pathology, which is somewhat in line with the surgeon's observations:

Start of 2018 a needle biopsy and an excisional biopsy showed ADH, ALH, LCIS in my left breast. After failed attempts at Exemastane and Letrozole, I started Evista/Raloxifene on Aug 15, 2018. In Dec 2018 I had a needle biopsy on the right breast that showed "a single minute foci of ADH" in microcalcifications. Since the protocol is to excise ADH if not all of the calcifications have been removed in the needle biopsy, I scheduled the excision for March 2019. In Feb 2019, after 6 months of Evista/Raloxifene I stopped due to leg cramps, especially at night. The excisional biopsy on March 22 was completely benign with no atypia. Normal! Now this was the RIGHT breast, and it was the LEFT breast that had been so busy, but all that atypia stuff affects both sides.

This experience demonstrates a 6 month time frame in which endocrine treatment occurred. After 4 months on Evista, the "single minute foci of ADH" prompted my oncologist to state, "That is a disappointment that you still have atypia after several months on Evista." My breast surgeon saw the glass half full and said, "Good. This is an improvement." But both doctors revealed that they expected the drugs to do something. And they had. After 6 months on Evista, with no drugs the 6 weeks prior to the excisional biopsy, the right breast is normal. My breast surgeon stated that she believes this progression is due to Evista and that I should continue with one of "the drugs."

Evista actually has the least effect on atypia of all the endocrine drugs, I believe. So my results should be encouraging for others on "the drugs" and the breast surgeon's comments were truly uplifting. (ahem)

A few days ago I began the new low dose tamoxifen, just 5 mg, (endorsed by 2 breast surgeons and an oncologist) but I am already thinking of going back to Evista and dealing with leg cramps, which are better than Tamoxifen's more global discomfort. After seeing these encouraging results of the latest biopsy my attitude of "I will not tolerate waking in the night screaming with leg cramps" has turned into "What's so bad about a little witching hour torture if it only happens a few times a month?" Rarely is there any feedback with these endocrine therapies, but these two anecdotes may provide a bit, and it is positive.

Of course all this could just be that on the right side they missed the bad stuff, but and it is still lurking throughout both left and right. Still I find myself a little encouraged and perhaps you may be too.