premenopausal- tamoxifen only or ovarian suppression + AI?

The SOFT study didn't recommend OS for women that didn't need chemo.

JerseyGirl, I would definitely recommend doing OS first to make sure you can tolerate it. You can always do an ooph later if the side effects are tolerable. I did OS for six months before my ooph in September. My only side effect was hot flashes. I chose to do an ooph but my situation is different. My mom was diagnosed with ovarian cancer at age 18. Even with that information, I still struggled with whether to have it done. I did keep my uterus which was not what my gyn initially recommended. It's a tough decision. You need to do whatever helps you sleep at night.

I'm 40 and have decided to do OS and have been on Femara for about 2 months now. I take it at night and don't have any major issues with it so far. (KNOCK ON WOOD)

As far as my side effects are concerned, I don't really have a lot of the full blown issues that some people are experiencing. Maybe I haven't been on the treatment plan long enough though, so I'm still cautiously optimistic. My biggest issues so far are stiffness in my joints. If I stay seated too long, moving around starts off stiff, but once I get going I'm fine. I do have an occasional hot flash, but nothing debilitating.

Technically I didn't need chemo either. I fell into the intermediate oncotype and elected to have chemo, so I'm not sure where that puts me in the soft trial studies in that regard. When comparing Tamoxifen with OS+AI my MO told me that the side effects of OS+AI were not life threatening.They might be uncomfortable, but were manageable. She mentioned the risks with Tamoxifen were things like cervical cancer, blood clots - basically the negative effects like you would anticipate with a birth control pill. She said those side effects were on the rare side, but they still needed to be considered.

Hey Tshire,

I'm in a similar position to you, although I am at a higher risk of recurrance. I recently spoke to my oncologist about hormone therapy and she was advised that I am to go on the default- tamoxifen. However, I've also done my own research and read about the soft trial. I'm definitely leaning towards aromasin and ovarian suppression over tamoxifen, esp with the chances of recurrance being1 in 3 with tax and 1 in 6 with aromasin and ovarian suppressor. I've heard the latter is more effective in young women, who have a different tumour structure to older women. I will definitely be bringing up this with my oncologist on tuesday. I'm already on zoladex (ovarian sup) during chemo so used to the hot flushes and other menopause S that come with this drug. For me reducing the risk of recurrance is more important than dealing with side effects. I'm 34

SoCalGrl, were you given a choice of doing chemo? What tipped the scales for you? I have an 18 oncotype and my MO was initially in favor of chemo, then suddenly ambivalent, suggesting that it would do little good for luminal A cancer like mine. Just wondering how you made your decision as I am gripped by indecision right now. Incidentally, I am also a SoCal girl.

Kessa619 - My MO recommended chemo because of my Oncotype score. (I go to UCSD Cancer Center in Vista.) My score fell into the intermediate area so I probably could have gone either way, but she told me that the chemo I was going to have was "chemo lite" and the regimen is tolerated very well, especially due to my age. I also considered my mitotic rate and Ki67 score when making my decision so that might be something for you to look into. I really didn't want to do chemo and was leaning towards declining it, but ultimately decided that I wanted to do everything possible.

My MO was right - the chemo was manageable. I just felt like I had the flu for a few days after each treatment. If you have any other questions, feel free to PM me. I'm guessing you're in San Diego, hence the 619 name so we're pretty close.