Changing to AI/OS from Tamoxifen after reviewing SOFT study?

Cryan, I want to make sure you understand your low oncotype score is designed to give an indication of whether or not you can forgo chemo, but it assumes you are taking hormone therapy. Be sure to talk to your MO about the side effects and see if he/she can help before making any decision to quit.

Lala, Kadyann, taking tamoxifen for a few years and then switching to an AI is one of the more recent recommendations, and I think they have found that with doing tamoxifen a few years and then AI improves overall survival, but mitigates that added risk. But Kadyann, I can't answer the question about weakly positive, except I do know someone who is weakly positive, and her onc also believes that positive is positive.

Good luck, Steph. I hope you have a smooth recovery.

Hi DiDel, I had Zoladex injections monthly, and Letrozole. The Zoladex stops periods and puts you into chemical menopause (I think), allowing you to take an AI. Sadly I couldn't tolerate the Letrozole so am now on Tamoxifen. But as far as I know I am still in menopause. From what my Doctors told me if I had stayed on Letrozole, I would have had to continue the Zoladex injections.

thanks ladies...I'm dreading this especially since I just watched a video on how the shot is administered.

I agree, Tresjobli. Zoladex is not horrible in relation to other stuff we've all done, but I do agree that Lupron is an easier shot. I started on Zoladex and then they switched me to Lupron. It doesn't really hurt at the time or later. So get Lupron if you can, although my current insurance won't pay for the 3 month shot.

Hi - new here. Just finished surgery (April), 5 months of chemo (May- Oct) and 6 weeks of radiation and now moving on to drugs. Got big surprise this morning when my mo wants to do AI plus OS - no tamoxifen. I'm 47 and no period since 1 month into Chemo (last May). Had high (32) oncotype which is why chemo for my 1.2 cm stage 1 tumor. I'm considered pre-menopausal since still had period at diagnosis and cessation was caused by chemicals. She says new studies show that OS is essential and that AI is now the better way to go instead of starting on Tamoxifen and switching. But she said that if side effects are not good, she will change to Tamoxifen. She doesn't suggest oophorectomy unless bad effects of shots. So confused. really thought I'd go right to Tamoxifen and now have 2 weeks to decide what to do.....

thanks Readytorock - hope I can figure this out quickly. I already have hot flashes, weight gain and tiredness from all the treatment - not sure it can get that much worse (we'll see....) might do ovary removal, not sure of that yet either - but I can figure that out later. Did your MO explain why AI? almost all the studies I'm reading say they are not sure about long-term outcomes for pre-menopausal women with AI as opposed to TMx switiching to AI later. I trusted MSKCC with chemo choices (after getting 3 opinions) and now wonder if I shouldn't question this too. But I hate the tension of deciding. ugh

Amy

yes - I read study - thanks.

A

The 2015 San Antonio Breast Cancer Symposium (SABCS) is wrapping up this weekend. It's a bit overwhelming to digest the data dump of breast cancer articles and videos. In this 7 minute summary video, Dr. Polly Niravath of Baylor College of Medicine discussed the SOFT / TEXT trials in a presentation called: "Adjuvant endocrine therapy: Is the price of forever too high?"

~4 minutes in, she discusses common side effects (toxicity) of ovarian suppression.

Hi all .., Happy New Year🎉🎉🎉🎉

It's been a rough start to the year as I'm stressed thinking of what lies ahead for me.

I was surprisingly diagnosed with a chest wall recurrence in November after much discussion and scans which were all clear...I've decided on Radiation therapy only to the tumor site incision which is approximately 4 " long and 2 " wide. They wanted to do whole breast ..sternum..supra clavicle and axillary nodes but I felt like that was overkill for a 5 mm tumor and negative nodes.that's being put off another month as I have 3 abscessed stitches that first must heal. I pray they heal so I can still have this treatment. I'm scared to do radiation but more scared not to.

I am also going to be doing OS zoladex (I asked about Lupron mo said let's try this first) then he said I will do for 3 months before adding Aromasin. I'm honestly so depressed and can't stop crying over being in this situation , again. I felt like I was just getting back to life and feeling like myself after 8 reconstruction surgeries . Side effects of chemo and that horrible tamoxifen which failed me miserably . I hate the thought of my life on hold for another year as I heal and adjust to these new drugs. The only positive is that I have a very good team who all seem to understand quality of life and my mo promised me we would keep trying to find the right combination of drugs I can handle and still feel good. I am also thankful for everyone here who understands my feeling which I can't share with anyone else. I hope this combo of drugs does the trick and that the side effects are minimal . Sorry had to vent a bit

Hugs to all that are struggling

Diane

thanks two hobbies for the words of encouragement. I'm just up one day down the next but support from everyone here helps.n

Diane

Thanks BethL I am so not looking forward to any of this, I just had a bone density scan so I will find out if I will need prolia or Zometa

I am waiting for incision to heal to start radiation . .another thing I'm not looking forward to.

I hope it's not as hard of a transition as I'm imagining

Diane

DiDel--

I am so sorry you are going through this. I know how hard it is to be diagnosed AGAIN. I found the lump in my breast the DAY AFTER I finished radiation for sarcoma. And prior to that, I battled melanoma. It's a crazy, unfair life sometimes... but you can do it! So many of us have...

I was on Tamoxifen for three months with few side effects (mainly hot flashes). However was recently diagnosed with a thickened endometrial lining - common side effect. Now will be requesting a switch to AI (with Lupron) as I consider (again) having my ovaries removed if I'm not post menopausal. Still hard for docs to tell with certainty. It has been almost a year since my last period and first chemo treatment. I have a similar feeling to yours that I may want the entire uterus removed to avoid later issues.

Thanks Lala. That's very helpful. Did your oncologist help with the decision or only your gynecologist?

I just finished my 5 years of femara, and onc seemed to be okay about stopping it since my DEXA scan showed my bones were being affected (anywhere from a 2-5% decrease) even though I had taken zometa back in 2010. Boy, did I do a happy dance the day I got to quit that crap! I'm feeling so much better!

Now yesterday, just 3 months after stopping the femara, he has decided that it might be smarter for me to stay on it for another couple of years! What????????? He said I was in the gray area, but he definitely implied that if it was him or someone he knew, he would continue it, mostly because of my age (45). He has left the ultimate decision up to me.

Here is my situation: Only weakly ER positive (10 percent); Hysterectomy/Ooph in 2010

Femara affected me almost immediately, although I don't know how much was the femara and how much was the instant menopause from the hyster/ooph. Within 2-3 months, my cholesterol shot up 50 points; liver numbers ALT went up from 20-30; weight gain of 10 pounds (I know not much, but I was only 105 pounds before so that's a 10 percent increase. Plus I have been consistently 105 since my 20's, never fluctuating more than a pound or two.) Thryoid TSH shot up from under one to over two points (still within normal range). All of these numbers stayed pretty consistent to these through out the 5 years of femara, never going back down to my original numbers. I put up with the Joint stiffness and pain, as well as the terrible hot flashes and painful, dry sex, because I knew I had to!

Now I don't know what to do! I don't want to go back on Femara, but I'm trying to figure out what I SHOULD do! I know the studies show 10 years of tamoxifen is better than 5, but what about femara, especially since my cancer was only weakly ER positive???

Help!!!!