Arimidex as Neoadjuvant therapy?

Dawn1027

I am being treated for Stage 2B IDC 6.7cm ER+/PR+/HER- (DX 02/15/2019) with Arimidex in lieu of Chemotherapy. I had a Mammaprint done and it showed that chemotherapy would only be less than 1.5% more effective than Aromatase Inhibitors to shrink my tumor before surgery. So rather than subject me to the side effects of chemo, I am taking Arimidex to shrink the tumor. Has anyone else has this therapy before surgery? Was it effective? I'm not sure if I should get a second opinion?

Hopeful82014

Hi, Dawn -

I had neoadjuvant letrozole (not Arimidex but also an AI) for 7 months. A re-biopsy at 5 weeks use showed a strong response and surgical pathology after 7 months showed the tumor was 95% eradicated. I did still have viable cells in 2 nodes but the growth rate had dropped to 1%. I had hoped for pCR but since ER+ IDC doesn't usually achieve that it wasn't surprising that there was a small amount remaining. My surgeon, oncologist and radiation oncologist were all very pleased with the results.

It's my understanding that neoadjuvant endocrine therapy is being much more widely adopted in the US. In the UK it's been used for years.

Go ahead with a 2nd opinion if you'd be more comfortable but don't worry that you're being offered sub-standard treatment at this point. I would hope that there are plans to do some imaging or re-biopsy to check for response; you could ask about that if you don't have that info already.

FWIW - my surgery was 4 years ago this month and so far, so good.

It can feel a bit odd doing neoadjuvant AIs - everyone else is talking about chemo or moving ahead with surgery while you're waiting to see how you respond but I felt it was worth it. If nothing else, I know how effective the AIs are for me.

Good luck - send me a private message if you have questions or need support.