I'm very close to completing menopause but I recently had the genetic test that shows how efficiently you are metabolizing tamoxifen, and I fell in the group with 31-50% reduced levels of tamoxifen's active metabolites. Right now I'm trying to decide between staying on tamoxifen but increasing the dose to 40mg, or switching early to an AI and adding OS. It would be a simple choice except for the OS, considering that I have only had one period in the last 9 months and my FSH was at menopausal levels in February. It will be hard to know when to stop the OS so I will most likely end up on it longer than necessary, and with the possible added side effects of that.

I have a few questions.

For anyone who has made the switch, how long did you have to receive the OS before you were able to start taking the AI? Did you continue on the tamoxifen in the meantime?

I am 35 years old, diagnosed in June with ER+ IDC, 4/28 lymph nodes. Mastectomy, chemotherapy, and will start radiation in a few weeks. From the start my MO said OS or ooph + AI due to my age and the SOFT study. I got my Zoladex shot at my fifth chemo and then three weeks later, at my last chemo, started on Aromasin. My Zoladex implant is every three months. The shot, as intimidating as it looked, really didn't hurt. I had quite a bit of back and hip pain when I started the Aromasin, but two weeks in and I feel okay. If I'm active nothing really hurts too much. I had more hot flashes on chemo than I do now. So I'll stay on the Aromasin unless side effects become unbearable. Then my MO said I can switch to OS + Tamoxifen. (He also figures I'll get my ovaries removed at some point.)

Rozem...he said 5 more years on Tamoxifen. I guess there's been no recurrence so if it's not broken, don't fix it? Not sure.... It's all so complicated.

Hi nye1980, I have a very similar diagnosis to you. I have been on Aromasin for 18 months and had a complete hysterectomy a few months ago at age 34, after being on zoladex for a year. My oncologist has also alluded to possibly switching to Tamoxifen later on, as I also have osteoporosis in the mix. I find the hot flushes intense and am thankful when there is cooler weather, but overall I don't feel too bad on Aromasin thank goodness. I hope you find the same.

Thanks for this thread, I read it all. I am 43 and I had surgery, chemo and radiation for stage 2 (small tumour but 1 lymph node was positive) over the last year, have been on tamoxifen since May and OS (Zoladex) since September. I was terrified of both but I am okay...some joint pain in the mornings, some dryness, some hot flashes, but nothing unmanageable.

I know my MO wants me to change to aromasin, and having read the SOFT study carefully...I agree (I am a bit older than the target age, but not much, and was still absolutely premenopausal until I went into chemopause...never got my period back before I started zoladex), but I am also scared to mess with what is working. Still deciding what I will do, but glad to learn a lot and read lots of experiences.

Kadyann, do you have more information about this that you have commented? "My other gripe is how does it figure for someone who is so weakly positive. It has been explained to me that tamoxifen works no matter what % of positive but AI effectiveness is directly linked to that percentage." Does this mean that if the receptors percentages are low, tamoxifen works better?

Anyone?

My precentages are 35% estrogen and 5% progesterone and I'm researching which option would be better for me.