Should I be considering Ovarian Supression + AI over Tamoxifen?

I wrote a longer reply to your post on the "Young" board, but I personally am going to push for this option. As inks said, the shots are reversible so you could test drive it and switch back to Tamoxifen if there's a bad effect on your heart and bones. I don't know if you're planning on having kids but the shots also mostly reverse themselves in women as young as us and Tamox can have adverse effects on fertility too (ovarian cysts, etc). As far as quality of life, I'm not going to lie, I've been out of chemopause for a few weeks and it's lovely (no hot flashes, sex life much better) but I still consider OS+AI a good investment in my future, at least for the first few years when my recurrence risk is the highest. 3-4% is significant if I'm in that percentage!

this is a tough one...I recently asked my MO at Dana Farber about the study results and if they have changed their standard of care practices based on it.  She replyed that they are offering this as an option to "high risk patients" , you are really really young so this of course is a huge factor.  If you were 3C and over 40 then absolutely IMHO but at 29 wow you are very far from natural menopause.  You could try the zoladex shots with an AI and if you cant tolerate go back on tamox - at least this is reversible unlike an ooph

I hear you, Ann.  Go with what your inner self is telling you.  My MO and BS did not want me to have my ovaries out but my inner self was confident and strong that it was the right thing for me.  It took 2 months of me presenting my case before my MO finally gave the ok.

You will make the right decision for YOU.

dutchchris - the study everyone is referring to is the preliminary results of SOFT and TEXT - more data to be released in December which it seems like most ONC's are waiting for.  Initial results are showing some benefit to an AI+ova suppression in pre-meno women (3-4%). 

you onc is doing ova suppression plus tamox (same as me) which I believe carries the same risk as ova suppression + AI  - its the ova suppression that causes the long term health issues so Im a little confused as to why your onc is telling you this is better?

Hi everyone,

Just saw my MO on Tuesday (last chemo) and mentioned the meeting to happen in Dec. About putting pre-meno women on AI+ovary suppressant. She wants me to be on Tamoxifen till then and will decide after that meeting if we need to change over.

Peacestrength - what your estrogen dominace? I am at 95% + ER and 85% + and at one point I was thinking of taking my ovaries out but I don't know if I am ready for that, worried about the brain effects but will do a better research. I have 6 frozen embryos (I am 33) and I won't become pregnant (hubby doesn't want me to and the MO said that if I were her wife she wouldn't let me either).

MaxineO - what kind of diet changes did you make? This last round of chemo has been very bad on hot flashes and night sweats for me.

Hope you all have a great weekend.

Lolis - I too just noticed your question.   I was estrogen dominant before I was dx with bc.  So, it wasn't a surprise that my bc was highly er positive. I was more er positive but my progesterone was fairly high too.

For me, having my ovaries removed helped ease my mind that much of my estrogen was shut down (I had high estrogen for several years prior to my dx).  You will make the right decision for your specific situation.  Everyone's situation is unique.