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Aromatase Inhibitors: Did you decide to go on them or not?
Nanaloves: I’m about to start arimidex and just feel that the contraindications , bone issues etc. are overwhelming. I’m 70 years old, dodged a bullet I feel with zero stage DCIS but the follow up is pretty much no different then if it was more aggressive. I’ve just done 33 treatments of radiation and now they advise arimidex as a preventative. I’m not sure with the beginnings of arthritis and lower back. sensitivity already that I should take it. Anyone not take it and not have a recurrence within the 5 years.
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The aromatase inhibitors stop the production of estrogen. Estrogen helps support bone renewal. Pre-menopausal women are said to have an 'estrogen shield' protecting their bones to some extent. That is lost (though not 100%) with menopause and is one reason that many women take 'hormone replacement therapy' after menopause. Estrogen does a lot of other things as well. I'm not sanguine that it's other functions are getting due attention. Loss of bone density is so obvious that oncologists have to address it for patients on anti-estrogen therapy.
My response is simple… you don’t need to know what you don’t need to know. Personally, three weeks out from a lumpectomy, margins clear, staged 1bNX, I’m looking forward to my radiation “rehearsal” and then (I hope) an accelerated partial breast course of treatment. My surgical teams calls my pathology report “fantastic,” and for now, that’s all I need to know.
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2 Reactions@slfisher1976 I didn't remember what that classification meant.
In stage 1A breast cancer, the tumor measures up to 2 centimeters, but there’s no lymph node involvement. With stage 1B breast cancer, the tumor is less than 2 centimeters, but there are small clusters of cancer cells in nearby lymph nodes.
and
Stage 1B: Cancer between 0.2 mm and 2 mm is found in the lymph nodes (the breast tumor can’t be detected or is smaller than 20 mm).
The NX means the lymph nodes cannot be evaluated.
Not sure what it means if the nodes cannot be evaluated but you are 1b!
No offense, but it seems a lot of oncologists are cheerful and reassuring.....
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1 ReactionActually, according to my surgeon, nurse navigator, radiation oncologist and medical oncologist, and pathologist, Stage 1b does NOT need lymph node involvement to be classified as 1b. In my case, the size of the tumor (6 mm) was enough for it to be considered 1b rather than 1a.
That was what I was saying, sorry to be unclear. I was saying that 1bNX seems like a contradiction, since they were saying 1b supposedly means something found in lymph nodes, and NX means the nodes cannot be evaluated- kind of a contradiction.
And no offense, but why ever shouldn’t they be cheerful and reassuring? Should they be gloomy and in utter despair as a general rule of practice?
The 2 pathologists who independently wrote my report (and of whom I have no knowledge as to their cheerfulness) BOTH classified my tumor as 1b. My surgical and medical team concurs. I had a negative lymph node biopsy and no lymph nodes removed. It was definitely 6 mm with clear margins. And that’s my story.
I’m here to share, not to be lectured to or scolded.
I think there is misunderstanding here. I was just asking about the contradiction between 1b and NX.
I have noticed a chirpy quality to my two oncologists. It is our choice whether to believe their affect or not. Not judging at all.
Sorry if I expressed myself in a way that made you feel that way. Not intended. I was just curious about the classification especially NX.
Here's how Sloan Kettering and two other sites define Stage 1B. M.D. Anderson uses the same standard. As does my oncologist at Cleveland Clinic. The definition is the same across the industry.
Sloan-Kettering:
Stage I describes a very early stage of invasive cancer. At this point, tumor cells have spread to normal surrounding breast tissue but are still contained in a small area. Stage I is divided into two subcategories:
In stage IA, a tumor measures up to 20 millimeters (about the size of a grape), and there’s no cancer in the lymph nodes.
Stage IB can be described as either:
a small tumor in the breast that is less than 20 millimeters plus small clusters of cancer cells in the lymph nodes; or
no tumor in the breast plus small clusters of cancer cells in the lymph nodes.
https://www.mskcc.org/cancercare/types/breast/diagnosis/stages-breast
Cancer Center:
Stage 1A: The tumor is very small and has not spread to lymph nodes.
Stage 1B: Cancer between 0.2 mm and 2 mm is found in the lymph nodes (the breast tumor can't be detected or is smaller than 20 mm).
http://www.cancercenter.com
BreastCancer.org:
In general, stage IA describes invasive breast cancer in which: the tumor measures up to 2 centimeters (cm) and the cancer has not spread outside the breast; no lymph nodes are involved
In general, stage IB describes invasive breast cancer in which: there is no tumor in the breast; instead, small groups of cancer cells — larger than 0.2 millimeter (mm) but not larger than 2 mm — are found in the lymph nodes
or there is a tumor in the breast that is no larger than 2 cm, and there are small groups of cancer cells — larger than 0.2 mm but not larger than 2 mm — in the lymph nodes
http://www.breastcancer.org
But NX means "hard to interpret lymph nodes." Confusing.
I agree. It doesn't make sense. I had a small tumor (7mm including clean margins) and clean sentinel lymph node biopsy. Thus a Stage 1A. [And thank heavens it was caught during a routine, overdue mammo and ultra.]