MRI results

Misty--so happy to hear the good news! If you have any questions about the tamoxifen (or LCIS), don't hesitate to PM me, I know exactly what you are going thru.  ("been there, done that!")

Anne 

Misty,

I ditto what Anne said!

Kimber

Misty--I've also read that LCIS is usually ER positive in most cases. My docs said I could take tamoxifen either way, if I wanted to. At the time I was diagnosed (almost 5 years ago), tamox was the only thing for LCIS; now people can choose to take Evista if they are post menopausal.

In this study of 50 samples, all were ER+ (both ER-alpha and ER-beta positive) and E-cadherin negative.



http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2559.2007.02689.x?



In this paper of 30 subjects, there was more ER-alpha positivity than ER-beta positivity, implying there was some ER negativity. http://www.springerlink.com/content/a3796256072008j5/



Note in the NSABP study, tamoxifen reduced the number of ER+ invasive cancers, but did not affect the number of ER - invasive cancers." Tamoxifen administration resulted in a 62% reduction in the rate of ER-positive invasive breast cancer but did not reduce the rate of ER-negative breast cancer." http://jnci.oxfordjournals.org/cgi/content/full/97/22/1652 (Note that only 6% of the partipants had LCIS.)



The manufacturer of tamoxifen says it should only be given for 5 years. I think there is some data (naturally not on LCIS women, or at least LCIS women only) that advocates switching to an AI. I don't think they've established how long AIs should be given.



I've seen more than one paper that opines that the risk of recurrence for invasive cancer goes down after 5 years. I've also read papers that the risk does NOT go down for LCIS women. But I think the risk in general is lower for LCIS women than it is for invasive.



Gotta go get my zzzzzssss...

Aromatase Inhibitor. Usually given to post menopausal women who have had breast cancer.

Misty---Early on my oncologist said "maybe arimidex when you finish with the tamoxifen", but then back-peddled over time, saying that the AIs (arimidex, aromasin, and femara) have not been tested long enough with LCIS. I asked him about Evista after I became menopausal (immediate surgical from total hysterectomy due to large ruptured ovarian cysts; which are NOT a common SE of tamox--rare) and he wanted me to stick with tamox as it  has been used longer and more is known about it. He said maybe no meds after I finish the tamox, but my pcp mentioned

Evista and even though I'd really like to be done with meds, I may try it as I have early osteopenia (it would help to prevent both osteoporosis and invasive bc). Tamox is generally well tolerated with hot flashes being the most common SE. I would recommend a yearly transvaginal ultrasound to monitor both the uterine lining and the ovaries.

Anne