Aromatase Inhibitors: Did you decide to go on them or not?

In Japan, they prescribe a prescription-strength use of Vitamins: K2 MK4 and K2 MK7, A & D. Google and you will see the amounts.

I did extensive research, and talked to my oncologist about it at length and on several occasions. My ILC was 7mm stage 1A, no mode involvement and caught early. I had the genetic testing and fortunately do not have any genetic concerns, and cancer markers were very low. I had a lumpectomy and radiation. My risk of recurrence before radiation was less than 5% after 9 years. My oncologist told me that the AIs would decrease my overall risk of recurrence, after radiation, 1%. I have chosen to go for quality of life at this stage and am not going to take them for now, and hopefully ever. I am approaching 70 and figure the next 10 years will be the most active I've got. I understand my risk factors, and am willing to take a little more risk to maintain the quality of life I have. It's a tough decision, but I have complete peace around my decision, and know it is different for everyone. Good luck!

I have less than 1cm ER+, PR+ HER - tumor in mastectomy breast. They think a new primary tumor after mastectomy 22 years ago. Awaiting lymph nodes diagnosis. My current tumor is small < 1cm. I am 70 years old. Have significant back issues and proven osteopenia. Surgeons have pushed hard for hormone blockers, I have resisted. Suspect they would want to add diphosphate meds (Fosamax, Bonita, etc) to booster my bones. My dentist said I would need to get as much dental work as possible done before starting biphosphates as they have a side effect of possible jaw necrosis. Additionally the medication stays in your bones for 10 years or more so even if you stop the drug the risk of jaw necrosis doesn't go away. I haven't seen oncology yet but I am pretty determined that I am open to radiation but not the hormone blockers. It has taken 2 years to adjust to my back pain and I don't want more pain. Have darling grandchildren to play with. I will listen to oncologist. I declined tamoxifen 22 years ago, was raising 3 active children and didn't want the blood clot risk. I should say I don't react well to medication sometimes so I am abundantly cautious.

I'm 77 and decided against radiation. Had 2 lumps and 2 nodes pos. ER+ onco at 19. I decided to just do Anastrozole. I don't have any clear side effects. A hot flash every now and then and I feel aches and pain that are tolerable,but can't attribute then to the drug.Could be just my age.
Just had my first bloodwork and all looks good. Been taking since June 2024.

@wyowyld I have a similar risk level as you, although some differences in type cancer. I’m 70 and am thinking along the same lines, I want to maximize the next 10 years while I’m still *young* 🙂
My latest beliefs after reading current research is that the radiation should kill the cells it touches, but there may be wayward cells that will continue to grow. It often takes years for a cell to get to a clinically significant size, so I’m going to be extra vigilant at 5 years, and then about every three years after. The hope that it will be seen at an annual scan - but that 3 years may be when it’s grown just large enough to be viewable.

I did not take the option for AIs. I had 100% ER and 95% PR so I decided I’d try tamoxifen. For me, the AIs spelled trouble as I’d already had de Quervain’s tenosynovitis twice in my hand and plantar fasciitis in my foot mutiple times. As well as osteoporosis. I didn’t like the cut-off of estrogen in other organs that AI causes, but just like chemotherapy, if the risk is high enough the side effects might not be pleasant but its doable in order to control the cancer. The choice of taking an AI is definitely right for some of us.

Tamoxifen was a problem at 20 mg but I’m tolerating 5 mg pretty well, I think, I may even stay on beyond 5 years as I see other benefits that the estrogen-as-agonist is providing. But, because of all the scans and issues that have occurred since the cancer showed up there are some things that are now on my radar and I’d want to make sure these aren’t being made worse by tamoxifen. I regularly check new research to see if tamoxifen is driving the adrenal cysts, the mild white matter hypersensitivities in my brain, the large increase in cherry angiomas (which I don’t care how benign they say they are - it is still angiogenesis and something is pushing the growths - never a good thing).

Boy, I *talk* a lot. Sorry for the long read.

Thank you for the thoughtful response and well thought out. We have been through much of the same thought process. My ER and PR receptors are considerably lower than yours. My doctor is monitoring every six months and rotating between MRI and mammogram. If I do choose down the road to add anything, I will also add low-dose tamoxifen. The recent studies have shown it is very effective and it sounds like the recommended dosage could be changed soon. Best wishes to you!