It's been eighteen months since I had a lumpectomy and declined aromatase inhibitors and I'm comfortable with that decision. If there were better, less toxic drugs for osteoporosis, which is possibly looming as I have osteopenia, I might have taken the AI despite nasty side effects.

But I looked at the effects of lack of estrogen on bones and cardio system, and was concerned about them. It helped that I had a low OncotypeDX risk of recurrence and other mitigating factors.

I also pondered an article in the New England Journal of Medicine in which an oncologist (the author of the article) declared that women aren't being sufficiently educated about the risks of aromatase inhibitors and stated that "we're giving 49 women these drugs for no good reason than that they might prevent 1 of the 49 suffering a recurrence." He argued that the toxicity of the drugs is being downplayed and patients are not being informed about the actual statistical likelihood of them helping.

It's a very personal decision that each person must make after considering all of the factors that apply. One path is to try them and, absent any debilitating side effects, consider staying on them if the other variables aren't limitating factors. At least one can discontinue them so the decision is not irrevocable (as are radiation and chemo choices).