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

I would love to see a study/data on results of breast cancer patients who did not choose AI. Thanks

I, too, struggle with similar concerns. My docs at Mayo, told me I didn’t have to have AI or radiation. BUT, they made me feel foolish in not choosing one.

I also have osteopenia and I asked my med-onco about Exemestane (Brand name Aromasin) which is an AI but is also steroidal and protects bones. I’ve been on it for about a month now with no side effects. I guess I could get side effects at any time but for now I’m happy to have none and better bone protection. This is only for post-menopausal women so if you aren’t there yet it’s not for you!

See my comment below. I am also in my 70s and concerned about bone loss as I have osteopenia. There is a steroidal AI that protects against bone loss. It is Exemestane (Brand name is Aromasin). After about a month I have no side effects. Guess I still could but for now I’m happy to have better bone protection.

I feel the same way as you. I have been taking AI for 2 months following a lumpectomy at the end of May. I opted not to have radiation. My oncotype was 5. I have been having some worrisome side effects from the Arimidex: my knees hurt worse than before and my dry eyes are also worse. The hot flashes are also annoying. I am very concerned about the long term effects on bone density, cognition and memory loss. I have been quoted the same percentages of recurrence as you have---6% if I don't take the AI, and 3% if I do. I am seeing my oncologist next month and will probably quit the AI.

@anjalima I finished my full course of an AI 🙂

To others, I did 5 years on letrozole and already had severe osteoporosis. My doc did not want me on Reclast or Prolia (long story) so I was unmedicated. I had a dip in bone density when first on letrozole (similar to the drop at menopause) and then the loss was much much gentler. I am now on Tymlos.

I was more afraid of cancer than any side effects, or bone loss. I felt safe on letrozole. I miss it!

My concern is how the AI will effect my heart. Letrozole is the prescribed drug but I am waiting to take it until I have a CAC scan next week. Am I the only one worried about cardiac calcification and a potential heart attack? Maybe this is not as great a risk as I have cooked up in my mind? (It would be nice to be wrong about this.) I feel like I have to choose between a BC reoccurrence and a heart attack.

My oncologist quotes very different percentages. In late May, I had an invasive DCIS lumpectomy with a lymph node removal that was negative. Surgeon says they got it all. My oncologist says if I don't take AI [anastrozole] I have a 7% chance of a recurrence. If I do take it for 5 years, I have a 3% [absolute] chance of a recurrence. This is making me re-think whether I want to risk the long term serious side effects like bone thinning, cognition and memory issues which can show up after 18 months to 2 years. I am going to discuss it with the oncologist in a few weeks during my next appointment.

I cannot common in DCIS invasive, so my comments are for IDC itself:

I don't personally know anyone who has cognition or memory issues on an AI, and I don't seem them listed as side effects.

I had severe osteoporosis, as I have written previously, and did 5 years on letrozole. Most people also take a biphosphonate during the AI treatment but I was unable to. I am now on Tymlos.

I would rather deal with some bone loss than cancer. The Breast Cancer Index, at the time I had that test, considered any risk over 4.7% as "high." It is up to your doc and you whether 3% versus 7% is significant.

Another factor might be your ER score. Since your Oncotype was low, I assume your ER% was high.

I would like to see study also