neoadjuvant hormone therapy suggested
Has anyone's treatment included neoadjuvant Tamoxifen? My MO said I was a great candidate for this to shrink my tumor (2.7cm) before surgery. I know it is common to do chemo before, but I have not seen anyone posts about hormone therapy before. If you had this as part of your treatment, how long did you do it? Were there monthly scans to check size? Of course, it is ultimately my decision (surgery now or later). I just want to make the right decision. My surgeon called this morning and said that this has been done more frequently in European countries and is just starting here in the US.
Comments
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Hopeful82014 did neoadjuvant femara.
I sure would like to know how well my tumor responded to HT. Best of luck with your decision.
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Does your doctor say why it's a good thing to shrink before surgery? How big is it? You'll still need surgery and radiation so in the meantime the unkilledcancer has time to spread
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Marijen She says it is so slow growing and that I am 100% ER+ and 100% PR+ are some factors. I trust her, I'm just a little freaked that it seems to be something newer. She has many years of experience and is actually on the advisory board for this website (BC.ORG). I will be getting RADS after surgery.
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I know someone in UK who had to delay surgery for almost a year due to another health condition (shingles), she started with hormone therapy. Her tumour shrank so much she went from a mastectomy to a small lumpectomy, and only from hormone treatment. I wish I had been offered it...........
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It's not that new. Five years ago I did neoadjuvant anastrozole for a year prior to surgery and was able to have a lumpectomy as a result. I had ultrasounds and/or MRIs every three months or so to check on the tumor size.
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I am currently doing neoadjuvant hormone therapy to shrink a 2.4cm tumor. It is also grade 1 or slow growing. It is somewhat worrisome to delay surgery. My surgeon recommended the therapy for six month due to the location of the tumor and my small frame, which will make immediate surgery difficult. I am participating in a clinical trial which is using two drugs, Anastrozole (Arimidex) and Fulvestrant (injections) to shrink the tumor. (I am post menopausal) I have only been on the hormone therapy for three weeks so it's too early to see results but I am optimistic that this will work. So far I have had fairly minimal side effects from the medications and able to maintain my normal schedule and activities. It's good to hear success stories about neoadjuvant hormone therapy!
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Hi - As Farmer Lucy stated, above, I did neoadj. Femara for 7 months prior to lx. In my case, the option was offered to see if we could avoid ALND, since I had a positive node at diagnosis, as well as bring down my high Ki67. While my tumor wasn't large, it's always good to be able to shrink it some but that was definitely a tertiary concern in my case. We were most interested in how my particular cancer would respond to A/I therapy.
I did not have a pCR, (which is less common on neoadj. hormone therapy) but we did get good results. Repeat biopsies at 5 weeks showed that the Ki67 had dropped to 4% (from 43%) and the tumor and node both shrank.
Ultimately, although I had one barely positive node (out of 5) and some isolated tumor cells, my oncologist felt that my response to Femara was strong enough that I could avoid chemo, as long as I remained committed to my A/I. Since I'm one of the lucky ones that doesn't have problems with Femara, I was happy to make that trade off.
I'm glad that I delayed surgery, as it gave me the opportunity to find out just exactly how my body responded to Femara, as well as to process the results of my genetic testing and took the pressure off of making decisions about the extent of surgery.
As others have pointed out, neoadj. hormonal therapy has been used extensively in Europe (particularly in the UK) with excellent results. There aren't as many in the US that are using this approach, which I think is unfortunate. Clearly, it's not for everyone but I think it could benefit many women, if only by giving them a demonstration of the power of hormone therapy. It seems that many women perhaps feel that either A) It's not as bad as chemo so it can't be that powerful or
They can't tell that it's working so have a hard time believing in its utility.
Good luck to everyone who is using this approach. I hope it works out well for you.
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