Nuts to request Tamoxifen?

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laurakay
laurakay Member Posts: 109
edited June 2014 in DCIS (Ductal Carcinoma In Situ)
Nuts to request Tamoxifen?
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  • laurakay
    laurakay Member Posts: 109
    edited April 2010

    I had a bmx last month, and good margins.  No nodes.  I had huge DCIS and 1mm invasion.  I'm ER/PR+.  The doctors have been reassuring about everything, and say no need for further treatment.  Most of the time I'm feeling very positive, but I must tell you my mother died of bc at exactly my age.  (48)  She had a large tumor, and a mx, and was also given the 'no need for further treatment'--had a recurrence a year later and died within a year after that.  If not for the cloud of that I would be on cloud nine about my doctors reassurance.  Most of the time I am.  I saw an oncologist on Friday who said he did not recommend it, but WOULD prescribe tamoxifen or raloxifine if I wanted it.  Would you consider this, if you were in my situation?  Now that it's been offered, I feel frightened NOT to take him up on it...In my dark hours I imagine the 1mm invasion slipped past my SNB, or the scraps of breast tissue left have cancer cells...well...you know....Any advice greatly appreciated.

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  • Beesie
    Beesie Member Posts: 12,240
    edited April 2010

    Laura, did your mother have invasive cancer?  If so, then her situation was completely different than yours.  Perhaps she shouldn't have been told that there was "no need for further treatment". Or perhaps she was treated according to the guidelines at the time, considering the treatments that were then available (no Tamoxifen or AIs or Herceptin, for example) and the knowledge that medical science had at that time (did they even test for HER2 then?  info on when radiation and chemo are appropriate treatments has advanced considerably in recent years). If she was being treated today, her treatment regimen might be quite different.

    As for your situation, the benefit you can get from Tamoxifen is approx. a 50% reduction in your risk.  Having had a bilateral mastectomy, your risk of local recurrence is only about 1% - 2% and your risk of distant mets (because of your microinvasion) is at most 1%.  So you can reduce your local recurrence risk to 0.5% - 1% by taking Tamoxifen, and you can reduce your risk of distant mets to 0.5% by taking Tamoxifen.  Is that worth it to you?

    Tamoxifen comes with risks of it's own, although the extent to which you personally are at risk depends on your age and your personal health history.  Here is some information about that: 

    http://www.bccancer.bc.ca/HPI/DrugDatabase/DrugIndexPro/Tamoxifen.htm (open the PDF file)

    http://www.rxlist.com/nolvadex-drug.htm#ad (Click on "Side Effects & Drug Interactions" in the left hand column)

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  • kittycat
    kittycat Member Posts: 2,144
    edited April 2010

    Wow!  My onco said no Tamoxifen because I was ER/PR-.  If I was +, then he would have made a rec to go on it or something like it.  Have you been tested for the BRCA genes.  Do your homework.  Don't jump into anything, but know your options...

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