Hormone therapy as neoadjuvant therapy in pre menapausal stage

Sk18 · March 2018

Hi Survivors & Fighters,

I have been diagnosed with Locally advanced breast cancer and started with first chemo of CEF on 24th Feb 2018. I am from India and hormone receptor (ER, PR) positive and Her2-negative, pre menopausal, 41 years.

Here most of the other patients with the similar profile are getting AC/T regime rather than CEF. So i took opinion from other known oncologists from good hospitals in last one week. And one of the oncologists suggested that since you are Hormone receptors (ER, PR) positive and ER score is 8/8 and PR 7/8, i will start with taboxifen 20 mg for 3 months as a neoadjuvant endocrine therapy rather than neoadjuvant Chemotherapy followed by surgery.

I am really confused what to follow and not follow...really need your help...

Also, if anyone has followed the hormone therapy before surgery, please share your response as my next chemo is due on 15th march..

thanks..

OCDAmy · March 2018

I was given 4 months of arimidex and lupron shots to stop my periods before surgery to try and shrink the tumor and avoid chemo. unfortunately it didn't shink it much (it didn't get bigger or spread) so we just went ahead and did surgery and then I had chemo. I felt like it was a waste of 4 months and wish I had just gotten the chemo from the get go.

Icietla · March 2018

http://www.cbc.ca/news/technology/common-chemo-regimen-inferior-canadian-led-study-suggests-1.572244

Icietla · March 2018

https://www.ncbi.nlm.nih.gov/pubmed/17953285

Icietla · March 2018

"However, to date, no taxane-based regimen has shown superiority over an adequately dosed anthracycline-based regimen using oral cyclophosphamide, such as CEF (oral cyclophosphamide with intravenous epirubicin and 5-fluorouracil)."10

Source: http://www.cmaj.ca/content/171/3/221

Icietla · March 2018

"Dose-intensified EC does not provide a measurable therapeutic benefit over CEF as neoadjuvant chemotherapy for unselected locally advanced breast cancer patients."

Source: http://ascopubs.org/doi/abs/10.1200/JCO.2003.05.135?journalCode=jco

Icietla · March 2018

https://www.uptodate.com/contents/locally-advanced-and-inflammatory-breast-cancer-beyond-the-basics#H16

Icietla · March 2018

Section 7 __

http://cdn.intechopen.com/pdfs/44802/InTech-Neoadjuvant_chemotherapy_role_in_breast_cancer.pdf

hapa · March 2018

I know of a few women that were on neoadjuvant endocrine therapy before surgery and it was very successful for them. I was started on endocrine therapy and it seemed to be shrinking my tumor, but I was rolled into a research study and now I'm doing endocrine therapy + Ibrance. I think a lot of cancer centers here in the US are moving towards neoadjuvant endocrine therapy for women with high ER+/PR+ tumors.

Is your tumor palpable? If so, I'd do another round of chemo if I were you and see if you can feel any shrinkage. If you are not seeing any shrinkage, then maybe switch to the endocrine therapy. Chemo isn't effective for a lot of women with highly ER+/PR+ tumors. But endocrine therapy doesn't always work either. And I don't think I've heard of anyone doing tamoxifen as endocrine therapy. Here they give Zoladex or Lupron to shut down your ovaries + aromatase inhibitors.

Hormone therapy as neoadjuvant therapy in pre menapausal stage

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