After prophylactic BMx, did anyone take tamoxifen or AI's?

AliceBastable, what you said is true, but if the surgery is truly prophylactic and no cancer is found in the final pathology, then there is no risk of mets and no risk of a localized recurrence in the scar tissue or against the chest wall. The only risk after a PMBX is the risk to develop a new primary breast cancer. For most women, after a BMX, the risk will be only 1%-2%, although those who are BRCA positive (or who have another genetic mutation) the risk will be higher.

light1candle, as an FYI, even for women with DCIS who have a a BMX, endocrine therapy is rarely recommended. The exception would be for those who are BRCA positive or who have close surgical margins. It's a simple risk vs benefit equation. If the risk of a localized recurrence is only 1%-2% (for those who had DCIS) and the risk of a new primary is only 1%-2%, Tamoxifen or an AI can reduce these risks by 50%, which at most is a 1-point risk reduction for each of these risks. These risks are for a localized cancer, which in most cases can be caught early and is treatable. By comparison, the risk of serious side effects from these meds falls in the 1% - 3% range (all possible serious side effects combined), depending on the age of the patient and other health conditions she may have. Some of these side effects, though rare, can be very serious, such as DVT/PE and endometrial cancer (for Tamoxifen) and heart problems (for AIs). That's not considering the quality-of-life side effects.

Even women who have DCIS-Mi who have a BMX usually are not prescribed endocrine therapy. With DCIS-Mi (my diagnosis), there is a very small risk of mets but the risk reduction from these drugs for someone who had only a microinvasion is just a fraction of a percent, not warranting the risks from the drugs themselves.

I had a UMX for DCIS-Mi and while my oncologist would have prescribed Tamoxifen if I'd insisted, he did not recommend it. From reading this board, his position seems to be pretty common.

So endocrine therapy after a PBMX when no cancer has been found and there is no genetic mutation present... I doubt that any responsible oncologist would recommend it.

I know the whole question can be confusing, but treatments are so individualized.  I had a very aggressive tumor, DCIS, which we caught early. I did chemo, then had a bilateral mastectomry, R side  prophylactic.  No nodal involvement, no mets, so I'm glad we did chemo first.  I'm 58, and I'm on anastrazole for the next five years, at least.  After that, my odds go down, (E0%P<5%, BRCA -, Genetic profile, neg.  I just want to never have to deal with recurrence again.  So far, I've had a post chemo/surgery pneumonia and heart attack.  I'm ready to feel better, dang it!!!

But, I still have to decide about a TAHBSO and reconstruction.  No implants, but maybe a flap.  We'll see.

---Gina