Pre-surgery hormone therapy

What's your MO's reasoning for this?

Neoadjuvant (pre-surgery) chemo is often done for those with large tumors, or who are HER2+ or TN or sometimes, node positive. But letrozole before surgery? That's more unusual, although I believe some studies have suggested it shows promise as a treatment regimen instead of neoadjuvant chemo. Is your tumor large?

Why didn't you have surgery right away? I know there have been some delays because of Covid but you were diagnosed in July, and I thought most delays were done by then.

TX, I would definitely get a second opinion as soon as you can. Even if he discussed this at a tumor board meeting. When I was looking for a second opinion I was told that it is good to go outside because often the people who comprise the tumor board can tend to have the same outlook. Good luck.

I had a large tumor and my MO tried to shrink it prior to surgery with AI. It reduced the size but not by much so I still ended up with MX andchemo after surgery but I have read some research that it can be quite effective in shrinking tumors.

Lorelei - Yup - you're in good hands at Baylor. Still, be sure you "click" with the docs you get. It's a long haul and you want someone you feel comfortable with who gives you all the time & information you deserve. If personalities don't match with one of the docs, don't be afraid to go for a 2nd opinion.

Good news. Saw the topic header and read since I have not heard of doing hormone therapy pre surgery. And with nodes involved. Wonder if it's just for lobular cases, all cases, what the actual criteria is? There's probably a study around somewhere.

Good luck going forward and thanks for sharing.

Late to the discussion too, but neoadjuvant endocrine therapy was also recommended to me instead of chemo.Two surgeons and one MO concurred. Another thought my nodal involvement was too much. It's been awhile and lots of other decisions since then, so I don't recall all the details, but my research and questions at the time also indicated it was becoming standard treatment for highly ER+ BC in Europe, less so here in the U.S., but that treatment was moving that direction in the US too. One surgeon at an NCI cancer center told me she'd had a couple of patients who got PCR, and others who were able to have BCS instead of mastectomy. Her hope was it would save the nodes in mine. It did not, unfortunately. The MO reasoning for doing it was to make sure my cancer was responsive to letrozole as you lose that opportunity if you have already done surgery.I did have clinical improvement, but not much apparent pathological response. Incidentally, The way they tell if the cancer is responsive is they rebiopsy the Tumor after one month and look to see if the ki-67 drops below 10. Mine dropped to below 1. But I still didn't get PCR or any nodal clearance. I have no idea why. They also reimage after a certain period of time to make sure it is not growing. The science as explained to me made senseto me at the time. I still don't know whether I made the right choice as I still had a lot of cancer in final path.
EDITED to add: Another NCI center recommended neoadjuvant chemo. I ended up doing letrozole before before surgery and chemo after. Had we known how many nodes I had positive (we thought there were onlythree), maybe it would not have been recommended. May never know if it was the right choice.