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Aromatase Inhibitors: Did you decide to go on them or not?
Breast Cancer | Last Active: May 12, 2023 | Replies (1190)Comment receiving replies
I feel the same way. I’m about to turn 68 and had a lumpectomy almost 2 weeks ago. My surgeon told me it was very early, very small tumor, etc., and recommended lumpectomy and radiation, followed by anti hormone meds. My follow-up was supposed to be with her nurse practitioner but now I’m seeing the surgeon again because she didn’t think the margins were wide enough. So. I agree-it doesn’t seem to matter-they want to go full throttle no matter what. I had a spinal fusion less than a year ago and am very afraid of what Tamoxifen and aromotase inhibitors will cause. I want to live a long time but I don’t want to to be a horrible, painful life. I am so very confused.
Replies to "I feel the same way. I’m about to turn 68 and had a lumpectomy almost 2..."
@jaynep what was your Oncotype score? That is a really important factor in the decision on meds. I don't view aromatase inhibitors or Tamoxifen as "full throttle." The Oncotype has saved a good proportion of cancer patients from the once assumed course of chemo. Chemo is full throttle! Many of us took aromatase inhibitors with few problems and if you do not yet have osteoporosis, bone loss either won't be a problem or can be reversed, most likely. Size of tumor is certainly a factor but you need to know grade, ki67%, and Oncotype or Mammaprint to know your risk. Unfortunately risk of recurrence continues and even increases for those of us with hormone-positive cancers.
Does anyone know what is a “safe” margin? From my pathology report “my invasive carcinoma distance is 0.3 cm from the closet margin”. In addition it reads “Specify closest margin: Deep”. 0.23 seems vey slim. Thanks
i feel the same way
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Did you by any chance have genetic testing that could give you an idea of risk of likely recurrence? A post-surgical biopsy yields the information as to whether there were clean, sufficiently-wide margins. If you weren't given a copy, you can ask for it. With a lumpectomy that recent, they can likely still submit the tissue for testing. Mine was submitted by my oncologist and I didn't see him until 8 days after surgery.
I'd probably consider getting a second opinion entirely from a different oncologist.. And, if I needed more surgery, get a second opinion on that too.
As to the post-surgery adjuvant anti-hormone drugs, many people have few side effects and tolerate them. With the caveat that the aromatase inhibitors will effect the rate of bone loss. And you might want to pay special attention to that and have a baseline DEXASCAN before starting them. They might have no negative effect on the spinal fusion.
I wish that more patients with breast cancer were offered the genetic testing. Size, location and stage of tumor are data points. Adding the data derived from an analysis of that unique person's genes is a very valuable data point as well. It helped my oncologist and endocrinologist (and me) feel OK with my decisions re: radiation and drugs.