If your pathology reports came back negative for cancer, what was your diagnosis? I assume that some cancer was found in a biopsy and that's what led to your decision to have the BMX? It's the nature of that cancer that determines your risk level that some cancer cells might still be in your body (beyond your breast and nodes) and that in term determines whether or not hormone therapy would be an overall benefit to you or not.

Okay, I understand. So here's why you are being recommended to go on Femara:

Topic: Susan Love, MD blog: "All Cancer is Metastatic"

While I don't agree with Dr. Love's choice of words (as you can see from my posts in this thread), her point is that anyone who has had invasive cancer has the risk that they may have undetected metastatic cells in their body. While all the scans and tests and the pathology of the nodes might appear to be cancer free, that doesn't mean that we really are cancer free. In your case, having had a very large tumor, the risk that some cancer cells might have escaped into your body prior to the detection of your cancer is greater. Hopefully chemo killed those cells off but there is no way to know if it did. The assessment of your doctors is that even appearing to be 'cancer free', your risk of mets remains high enough that it warrants hormone therapy.

Ultimately of course the decision is yours. This website might be helpful to you:

Breast Cancer Treatment Outcome Calculator

You can input the specifics of your age and diagnosis, and then see the difference that adding hormone therapy to your treatment plan will make to your long-term prognosis. I'd recommend that where it says "Display as" below the chart, you select "Pictogram". I find that's the easiest chart to interpret.

Hope that helps!

I am not sure if I will regret it or not but yesterday I chose not to take hormonal therapy. I had talked to four different women who refused it and they were all fine over 15 years later. By taking taxoxifen it would have reduce my chance off reoccurrence by 5%. In saying that this decision is not for everyone.

I chose to take the hormones.  I did not have to have chemo, but I did radiation and now anastrozole.  1mg.  I was nauseated for the 1st week or so, but it has gone away. My score was 7

My first diagnosis was 23 years ago - October, 1991. Stage 1, however the tumor was just under 2cm - node negative; ER pos. (they didn't do HER2 and all the other diagnostics back then) Lumpectomy/radiation. Oncologist advised chemo - I said, no. Surgeon advised no chemo given the slim, 1-2% survival and all the horrendous side effects. Took Tamo off and on for 3 months and became debilitated with headaches and muscle/joint pain. Stopped on my own accord. I thought I'd rather die than live my live with this level of discomfort.

Tamo is an old, old drug and they still use it even with the same toxic side effects. Now they've gone and designed a drug(s) (a variation on the theme of Tamo) and so now they tell you...well, the symptoms are not as bad as Tamo, but you might still experience muscle/joint pain and Oh, yeah...it also causes heart problems. Go figure.

During routine annual exam on November 5, 2014, Digital mammogram picked up a tumor on the radiated breast. Same surgeon who did the lumpectomy 23 years ago looked at the ultra sound and said it was a "second primary" , less than 1.5 cm and said it will be ER pos./ and HER2 neg. The pathology came back confirming his visual analysis Don't ask me how this genius of a surgeon could call it before the pathology was complete. Biopsy confirmed cancer; 1.2 cm; ER pos.; HER2 neg. Double mastectomy/no reconstruction on Nov. 12.

Met with oncologist yesterday. No chemo but he did suggest Aromatase Inhibotors (Arimadex). I told him I would think about it but as of now, I've decided not to. I am waiting to hear back from my surgeon as I trust his judgment more than I do the Oncologist.

Once I start Arimadex and it does spread, I can't repeat that medication again, much like radiation. I'm doing all that I can to eat well, exercise, supplements, etc., to take good care of myself, the rest is scripted.

There's another aspect to taking these toxic medications that rob us of our quality of life; now you read so much about stress and emotional anger impacting our long term positive outcomes with this disease; that all the negativity in our lives compromises our immune system, etc., ....well, how can living with nausea, joint/muscle pain, day in and day out not cause stress, anger and depression and have it all not affect our immune system?

I went 23 years the first time out with a larger tumor and if I go another 23 years, I won't even know my own name. If there's a spread, I'll just bank these hormone meds and use them if choose to. Besides, here's the bottom line. There's no rhyme nor reasons to this disease - unpredictable at best.

Susan Love? My surgeon calls her a fema-nazi. I read her book 23 years ago and didn't have much of an opinion about her as she had so many contradictions in that book. Toward the beginning/middle, she talks about cure frequently; some 20 pages out, she then cautions the reader to be cautiously optimistic and that the only time you know you're cured of this disease is if you die of something else at old age. Contradictions make me nervous, especially in books written by individuals who specialize in that field.

May God shine his loving, healing light on us all and shoulder us and give us courage to endure all this.

Tgtg, You're absolutely right about the weight gain and not being able to exercise due to pain. Yet another disconnect in treating us responsibly.

On the drive home, I was going over the conversation with this Oncologist and how he was asking me about family history of illness, etc. I mentioned to him that we had no history of cancer (although, how the heck would you know a 100 years ago), but we did have a strong history of heart disease; that my mother and all her siblings perished from heart disease. I also told him that I've had heart palpitations, that come and go, since I was a child.

So, based on all that information, he would still prescribe a treatment that would compromise my heart.....at my age!

Survival for us all is to stay on top of things and get educated. I heard somewhere this phrase: "that doctors are trained, not educated".

I am giving strong consideration to refusing AI. I was prescribed Arimidex but have yet to take a pill. I am 65, dx 1.5cm IDC. ER/PR+, Her2 -. Tumor was 95% E receptor +. No node involvement...0/4 and clear margins. Oncotype score 20, no chemo recommended.

I start Radiation next week. With a history of arrhythmias and hair loss, both of which are side effects of AI, I am very reluctant to start this medication. Yet the alternative scares me more...soooo torn.

Manu14...I have decided to wait and do exactly that. My radiation starts next week and I have an appointment with my MO in mid Feb. I am going to discuss my concerns with her at that time. The rad will have to be it for now. The idea of foregoing AI therapy altogether doesn't seem so "out there" after reading some of the posts here, and is something I am still seriously considering. Thx for your input.