AI vs tamoxifen

While there is a decrease in reoccurance using an AI over tamoxifen there is a higher risk of death, most likely due to coronary vascular disease.

Data interpretation is always tricky. Women on AIs in general are much older than those on Tamoxifen. Since CVD is at the top of reasons women die as they age, it's not a surprising finding. Also, post meno women also generally have less aggressive BC, so will die of something else. Younger women generally have more aggressive BC, so are at a greater risk of dying of BC. Now if the research found that women on AIs die of BC more often than on Tamoxifen, that would be noteworthy.

Well I tried letrozole/femara because it is supposedly better for my type of BC which is Lobular as you can see from my stats. This drug made me so ill, not just the aches and pains and feeling like an old lady but it was what it did to my heart, blood pressure and cholesterol that really worried me. So I had to stop taking it and now am on Tamoxifen. I am finding Tamoxifen much easier to tolerate although I do have a very sore elbow at the moment - just can't seem to win.

I am on tamoxifen and now post menopausal. The plan is 5 years of tamoxifen and 5 years of an AI. I asked my MO if I could just stay on tamoxifen for 10 years since I really have no side effects except some hot flashes. She said I could stay on tamoxifen for 10 years if I wanted, but also pointed out it (though rare) can cause blood clots and uterine cancer. We can't win can we?

Nancy

Wife hates blogs/forums - had bad experiences with them so she won't comment. I know, I know Mr/Ms Moderator this forum is for BC women only but I just wanted to show AL's don't work for everyone.

My wife, (now age 68) back in Dec of 2012 was diagnosed with Stage 4 ER+ breast cancer. One node and a small spot on the spine. After 3 infusions of AC she was clean except for the 6 cm tumor in her breast. The oncologist said since the cancer was responding well to estrogen blocker (aromasin) it was best to leave it be.

A little over a year later, Nov 2014, the aromasin stopped working. Cancer morphed and went crazy. She had a radical mastectomy and breast removal. A biopsy showed it to be ER+ and the oncologist prescribed tamoxifen. 19 lymph nodes were removed and 9 of the 19 had triple negative Metaplastic keratinized squamous carcinoma. A PET scan done after the surgery showed some cancer still in her armpit, probably spill over from the nodes. She had 4 infusions of AC, her lifetimes amount. No taxol as she almost died from it earlier. The before chemo PET scan showed an SUV of 5.9 of the triple negative. After the chemo it was 2.2 with 1 being the base. She's got 3 more weeks of her 7 weeks of rads.

The point is aromasin only worked a little over a year for her. Question, how many types of estrogen blockers are their? How many are left for my wife use before the situation get's real scary?

She has two cancers now, one ER+ PR+ HER2- and another metaplastic triple negative.

I was on tam then had my ovaries suppressed and tried an AI. Did Aromasin then Femara. I couldnt tolerate either. Vertigo, muscle and joint pain to the point where I could barely walk. I know there is a statistical advantage but I need to be able to function. My MO said she feels comfortable with me staying on the tamox. She said it's just important to stay on something

I am 60; 58 at DX. On Tam since May 2014. SE's are minimal. Hot flashes, leg cramps now and then. I have osteoporosis and osteopenia, so it was an easy choice for me. MO said we may do anohter DEXA scan next yr and see how my bones are, before considering a switch. I have read that aspirin may reduce the risk of BC recurrence and also blood clots...MO agreed that is was okay to take a low dose aspirin/day. I had a hysterectomy 10 yrs ago, so the risk of uterine cancer isn't a problem. Good luck with your decision!

rozem, how will you know if you are in "natural menopause"? My MO essentially said that now that I am on this lupron+AI, she won't be able to tell when/if I am in menopause. She implies that my only out is to have my ovaries removed. I am 51. I've have 3 shots so far. I don't find them to be a problem at all. But I otherwise, I am pretty miserable on this AI. And the next decade just seems insurmountable.

I think the only way to know if you're in menopause would be to stop the shots and see what happens. I'm 42 so I could have another 8-10 years before I'm in natural menopause. The shots aren't that big of a deal but I don't want to go every 28 days to get one. Especially if it's for 8-10 years. I'm not even sure my insurance would cover it for that long. I can't imagine my MO will think it's ok for me to become premenopausal again in five years. By that time they may definitely say ten years on an AI

yes i would stop the shots and see if my period comes back or get bloodwork to test my estridol level. Because im on Tam even if Im not in mebopause its still ok to take it. If you are on an AI and stop the shots and you come out of menopause then the AI is useless which is probably why your MO wants to remove your ovaries. You are much closer to natural meno then Mommato or myself. I really I am resisting removing them because i feel like even if I'm in natural menopause and they dont function anymore I'm still getting some sort of benefit? I dont know. All I know is that the few times that I've had a period i felt amazing. But alas with a tumor that was 95% positive for estrogen my days offree-flowing estrogen are over!

Mommato. Having a mom who had OvaCA would seal the deal for me- i would want them out. I will probably go down that road aswell. I was hoping that after my five years of Zoladex I could just stop and that my ovaries could kick in again and hopefully give me some of the benefit that I've lost with being put into menopause at 42. I haven't had this discussion with my MO because I have a feeling it's not going to be the news I want to hear. Of course I will do whatever it takes to stay cancer free