EVISTA for BC prevention?

My doctor, after my 2nd abnormal biopsy (ADH), wrote me two prescriptions and said to hold them until he researched the STAR study that had just been released. One was for Tamox the other was for Evista. He called me a week later and said to fill the tamox, Evista hadn't been tested or approved by the FDA for premenopausal women and I was still premenopausal. The STAR study only looked at post-menopausal women and compared tamox with evista.

Sheila

Kittygirl------I took tamoxifen for 5 years and now I take Evista for further preventative measures (I am high risk due to LCIS and family history of ILC). You can google the STAR study and it will give you a lot of comparisons between the two. I can try to answer some of your questions.

1. Evista is supposed to decrease risk up to 45 to 50% (as is tamoxifen)

2. SEs--the literature says hot flashes are common with Evista; there is a risk of blood clots, but it is very low and less than with tamoxifen. (I don't think Evista has the risk of cataracts or endometrial cancer as tamox does, but again, those risks are very low, less than 1%). Some people have no SEs at all from Evista; I have continued hot flashes, but mine are more from my lack of estrogen (lost ovaries) than from the tamox or the evista. I take a baby aspirin (81 mg) daily to decrease the risk of blood clots. I've tolerated both medications well.

3. There is no actual blood test or other method to tell if it's working in preventing bc (that I know of), but my recent DEXA scan  showed improvement in my bone density so I know it's helping my osteopenia.

4. I don't know how long Evista continues to work ( tamox reportedly works for up to 10 to 15 years after stopping); I know it's been studied for 8 years, I've been told I can take it indefinitely (people do for osteoporosis without problems).

5. In the STAR study it reported that tamox and evista were equal in terms of preventing the invasive bc's, but tamox was also able to prevent the non-invasive bc's (evista was not); so  while tamox has the risk of more SEs overall, it also is more beneficial overall. But they are both good preventative medications to use with high risk women. TAmox can be used during either pre or post menopause, but evista is only for post menopause (so far).   Even when I became menopausal (immediately from surgery), my oncologist wanted me to finish up my remaining 3.5 years of tamox before considering evista, as he felt tamox had been studied and in use longer. (about 30 years).

Anne 

The star study was a clinical trial that compared tamox and evista side by side for high risk patients that were post menopausal. They do give Tamox to the high risk premenopausal patients especially after a biopsy showing ADH or LCIS and a family history. My doctor suggested I take it after my first biopsy of ADH, I was only 44 and wasn't sure if I was ready for the menopausal SE as well as the possible uterine problems. 18 months later, my 2nd biopsy (opposite breast) showed ADH again and my doctor said that I had to take either Tamox or Evista, after he researched the conclusions from the Star study showed he couldn't give me the Evista, he had me take the tamox.  I started taking the Tamox on my 46th birthday. My 3rd abnormal mammo was 6 months later and showed DCIS.

edited to correct a mistake I had about the star study