Premenopausal women: Ovarian Suppression plus Tamoxifen or an AI

Hi, eloqui. 

I'm so sorry to hear about your diagnosis!

That is the treatment I am on. Part of what made that decision for me was my oncotype dx (12) and early stage/low grad diagnosis, which you can see in my signature. Supposedly for cancers like mine AI's or Tamoxifen are as effective as chemo with fewer SE. I also have a history of deep vein thrombosis (blood clots), and therefore can't take Tamoxifen, so if I want to take an AI, then ovary suppression it is! I know these drugs have pretty crummy SE even if they're not as bad as some of the chemo regimens, and five years is a long time to commit to, but I wanted to do everything I could to prevent recurrence or new primary cancer. I opted for a BMX, and after going that route, I decided I wasn't going to wimp out on the adjuvant therapy. I have made a promise to myself that if the SE become so awful that I can't function, then I can stop the drugs. So far, truthfully, they are not that bad. Hot flashes, yes, some joint and muscle stiffness, yes. I had a bone density test to get a baseline to watch for osteoporosis. In the meantime I'm doing everything I can to minimize those: my MO put me on calcium, vitamin d, biotin, and CoQ-10 supplements, plus recommended vitamin e for hot flashes. My GYN recommended evening primrose capsules for hot flashes too (one of the few natural remedies that's not also a source of estrogen). I'm working out with weight-bearing exercises (walking, yoga, strength training) at least 5-6 days a week. I am eating mostly a plant-based diet, etc. So far, all of these things are helping me feel pretty good.

It is so hard to make decisions at every stage of this stupid bc "journey"! I know I really agonized over this one. I'm 42, so not as young as you, by far, but it still was very upsetting to be thrown into instant menopause. In some ways I grieved more about that than the surgery. Anyway, I hope you get some good answers from folks here and that that will give you some clarity in your own decision-making! :-)

MJ

I am similarly struggling with whether I should have an oophorectomy + AI, or injections + AI.  I am 41, premenopausal, done with having children, and just sad about losing my vitality (separate from fertility; and I know: whether I remove my ovaries or have injections, I'll experience menopausal symptoms).  I am positive for the prothrombin gene mutation, so Tamoxifen carries higher risks of blood clots for me.  I am Stage 1, ER +, Her2Neu+, BMX with reconstruction, finished taxol, still doing herceptin.

Anyone been in this boat?  Anything you wish you had considered when making your decision?

I am on this treatment plan, first Tamoxifen the past few years, now more recently Lupron added.  I go for once-monthly shots because I wanted to ease into the whole thing and have a back-out plan if I really couldn't tolerate it.  I was 40 at diagnosis.

ChristyBird, I have a genetic blood clotting mutation and conferred with a hematologist before going on Tamoxifen. He gave me the OK. I have never had any clots, so he didn't feel that I was necessarily at a higher risk. I do take a baby aspirin along with the Tamoxifen. I am premenopausal but had chemo and have not had a period in almost 18 months although my MO and GYN both felt it would come back.

This is my first post to this site.  I was diagnosed at 37 in November 2007 with IDC followed with chemo, Herceptin, Femara. 

I had my ovaries removed in 2009 by strong urging of my oncologist.  None of my doctors let me know what kind of mess I was going to be walking into.  I did it only to greater my chances of not getting ovarian cancer, and I did it quickly before I changed my mind.  My emotional state after that was awful, and I was not prepared for it.  I tried different antidepressant medications to help me deal with everyday life.  Of course, medications take time to go through and I didn't even know if it would help.  Time went by and finally I had a hysterical breakdown at work in 2011and couldn't stop crying.  My oncologist put a medical leave in for me until I could get myself together.  I was very tired all the time and that made everything worse because I couldn't deal with anything.  I was diagnosed with a few sleep disorders and have been taking Dextroamphetamine (similar to Adderall) since then and am currently taking 7 other medications ranging from medications for my thyroid, acid reflux, anxiety, etc.. still to day.  I am so scared to come off any of them even today.  My work was not sympathic at all.  They started me back at the front desk.  I had been there for 12 years at that time.  What I realized is that when people cannot see you physically sick anymore and are not familiar with cancer, they have no sympathy.  If I could go back, I probably would have delayed having my ovaries removed.