When I actually began to research the 3 drugs they promote for adjuvant therapy, one oncologist said that Laetrozole and Anastrozole were "kissing cousins." Exemestane, however, is slightly different in its make-up and I would have been better off starting off with it, if ANY of them were appropriate. My current Texas oncologist says that, with my 20-year history in the MOST study and my damaged left knee and elbow (bicycling accident & volleyball dislocation) I was a poor candidate for any of the A.I. drugs, because they are designed to stomp out the estrogen in your body, and estrogen is essential for the pain-free functioning of our joints. Tamoxifen, on the other hand, a "blocker" drug, might have worked, but, of course, has horrible side effects such as endometrial cancer and the development of blood clots that can lead to heart attacks and strokes. Laetrozole is usually given to women in the U.K. and Europe first, because it has a slightly higher % of efficacy in trials. Anastrozole is the drug of choice for the average b.c. patient and Exemestane is not because Exemestane is more expensive. I actually went in and asked the pharmacist for the comparison prices, and it was definitely the more expensive drug, but one that had a chance of being less debilitating for the average user---but not for me. Every single visit I had as one of about 3,000 patients in the MOST study they did an MRI of my damaged left knee and X-rayed my other joints, and yet my oncologist blithely put me on Anastrozole less than a week out of surgery at a time when I was also fighting a seroma infection with 500 mg. of Cephalexan taken every 4 hours for weeks. He dismissed any stories of side effects, IN WRITING, saying, "The only side effect from taking Anastrozole is a little bit of achiness in your hands and fingers when you first wake up, and that goes away when you quit taking it." That is so wrong that I can't even tell you the distance between reality and wishful thinking on his part. When my knee actually blew out and put me in a wheelchair, he dismissed that side effect as "You're just old" and he only showed up in person for 2 appointment in 8 months. His "minions" (look-alike blonde P.A. girls with names like "Heather") always fielded my patient portal inquiries about ordering me a ki67, suggested BY MY SURGEON, with the response, "You would need to talk to the doctor face-to-face for that" and, of course, the doctor was seldom face-to-face with me from meeting #1 (Feb. 1, 2022) until October 3, 2022, the day we finally met to discuss my first post-operative mammogram (which I had to be wheeled to in a wheelchair). When I attempted to describe the hell I had been experiencing since the finding of my 11 mm. tumor on Dec. 7, 2021 and to ask him to please order the ki67 so that I would have some idea of the % of a recurrence (he refused to order an oncotype for me, saying, "You don't need one"), he said, "I won't order that for you. You'll have to get someone else" and get up and walked out. He had also gotten up and walked out of the prior meeting when I had a list of side effects that included teariness, mood swings, brain fog, excruciating back and joint pain, blurry vision and vivid violent nightmares that accompanied ongoing insomnia. That time he said, "Don't take it then" and got up and left. He was big on walking out with no discussion of any alternative plans of action or medications and I was never given anything for a truly huge amount of pain that I was experiencing. If I had not taken myself to the joint pain clinic in Chicago after my knee blew out on 9/15/2022 I would never have received anything for pain and, even then, I had only 15 Tramadol pills (50 mg.) for pain that kept me wheelchair bound from September 15, 2022 until March of 2023. I would love to report these side effects to the appropriate agency and ask the very logical question, "Why would they be prescribed to a woman who was in a clinical trial for osteoarthritis that was severe for 20 years?" I wrote a letter to the hospital where my dismissive oncologist was employed. They never answered it in any way, but I recently received a notification that Dr. Constantinou will be retiring soon. There are no better ones available in my geographic area, apparently, as, when I asked in Iowa City of the oncologist assigned me at the University of Iowa Hospitals and Clinics who would be a "good" oncologist in the Quad Cities, since mine was not attentive or compassionate or open to even listening to his patients, his response was, "Why do you think all of the patients in the Quad Cities come here?" (which, by the way, is a 3 hour round trip drive up and back).