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

The risks are very very low according to all my docs.

After a lifetime of western diet, I struggled with knowing what to eat and at first was hungry all the time. But over the past months, I’ve really hit my stride and find it's now easy and surprisingly cost effective to cut out meat & dairy. It helps to find friends and share recipes too. For supplements, I take glucosamine and a broad multivitamin mostly for the vitamin B12, D & calcium. I was taking fish oil, but now I’m not sure it’s a good idea for me. To make sure I get enough of the right foods, I use the app “Daily Dozen” for to track my day. Here is the website: https://nutritionfacts.org/daily-dozen-challenge/. It’s also good website for recipes. There are lots of websites with non-meat/dairy options for your favorite recipes. Click on Recipes: https://nutritionstudies.org/
Breakfast:
~Each week, I cook 1 cup of steel-cut oats & 1cup of barley (separate pots). That makes about 8 cups and I mix them together in large bowl with cinnamon & vanilla. I have that for breakfast every other day, adding blueberries, raspberries, mango, etc. No sweetener needed; it’s delicious! I often add an apple with tablespoon of peanut butter & large mug of green or oolong or chamomile tea.
Other breakfast options:
~whole wheat toast topped with mashed avocado and toppings like sliced cherry tomatoes, spinach, lemon juice, red pepper flakes, vegan parmesan.
~Whole grain bread topped with any kind of pure nut butter & a banana
~Whole grain bran flakes (with no additives at all) with ~¾ unsweetened non-dairy milk
Lunch or dinner:
~Every 3-4 days, I make a big bowl of chopped salad with diced veggies – whatever is in season like cucumber, red & green sweet peppers, green onions, carrots, radishes, cherry tomatoes and maybe cauliflower. Each day I eat 1-1/2 cup of this, adding balsamic vinegar & pepper for flavor and sometimes avocado slices.
~Cauliflower crust pizza –top it with sauteéd veggies… mushrooms, onions, tomato, etc. If you don’t want to make your own, Costco has a good cauliflower crust pizza (although not vegan).
~I usually have 2-3 favorite frozen crock pot soups in 2-serving packets. Here is my favorite vegan chili recipe. https://www.acouplecooks.com/vegetarian-chili/amp/
~For my easiest meal, I put frozen broccoli (or other veggies) in bowl, pour any kind of soup over top & microwave. The veggies double the soup volume and adding a slice of whole grain toast makes an amazing, easy meal.
~I sometimes buy packaged salad mixes and add extra veggies and/or avocado; whatever I have in fridge. Aldi’s has 3 good and inexpensive salad mix choices - just toss the cheese.i think their veggies are organic.
~Here's a yummy vegan sloppy Joe’s recipe: https://minimalistbaker.com/vegan-sloppy-joes/
~I keep home-made, frozen cooked lentils & black beans available and pop some into my soup or salad to bump up protein as needed.
~Mexican food is a great way to add beans and legumes to your day (although the cheese has to go or buy vegan cheese). I buy fresh salsa at Aldi’s and make my own batch of easy refried black beans with cumin & chili powder & freeze portions in muffin tins.
~Daily 2-3 tablespoons of mixed seeds/nuts and 1-2 teaspoons of flax seeds.
~I still eat some fish and eggs but am tapering off.
~4 servings of fruit – blueberries, raspberries, apples, cherries, grapes, bananas, oranges, lemon/limes, etc.
~Spices – cumin, turmeric, ginger, chili spices, cayenne, bay leaves, oregano, cinnamon, nutmeg, vanilla, peppermint…
~Treats – 2 oz dark chocolate with ½ C raspberries, 1 corn muffin… still looking for healthy treat ideas.
~Beverages: simply water with or without lemon and tea with non-dairy milk
I also try out vegetarian restaurants, particularly Indian food, to get new ideas.
Hope all this provides some insight; I’m obviously over enthusiastic about it! 😀 Wish my Mom (who died of breast cancer) could see how I’m eating the way she used to encourage me to do <3.

Would you consider yourself thin? Do you exercise ?

I am post-menopausal and the standard of care is to prescribe one of the 3 aromatase inhibitors. Tamoxifen is generally given to pre-menopausal women. I have done exhaustive research on the 3 AI's and, with misgivings, decided to go ahead with letrozole (Femara). I've been on it for a month or so and, even though I have no visible side effects, I would discontinue it if I was sure it is not or is only minimally effective.
I found no definitive answer to our question >> Do women with stage/grade 1 IDC get enough (or any?) benefit from taking estrogen suppressing drugs to balance out the side effects? One not-for-profit breast cancer source said that, once a drug dosage is established, there is no incentive for the manufacturer to do further dosage studies. But, just as the Oncotype DX test confirmed that chemo was not necessary for women with lower grade cancer, shouldn't there be studies that determine if AI's & tamoxifen are really effective for those (us) women? I'm continuing my search until when i get a second opinion from an oncologist later this month. Hopefully she will know if such studies are available.
This is truly a hard decision for each of us. Do we actually risk cancer reoccurrence by not taking the drugs and if so, by how much? Or do we take the drugs "just in case" and face potential serious drug side effects? I just met a woman through the Pink Ribbon group at Mayo who took AI's for 10 years and is now cancer free for 15+ years. She has a friend who quit after 5 years and had reoccurrence 6 months after quitting. That reoccurrence may or may not have been connected to the estrogen suppression. And there are women posting on the internet who never took the drugs and are cancer free. So at this point, I am not ready quit taking it but will do so if/when I find out it's not worthwhile. I wish you all the best of luck in making your decision.

Yes, my BMI is 22 which is normal but is now considered thin. I am not sedentary; I walk 10,000+ steps a day, sometimes do yoga & take classes like zumba. When I was diagnosed with BC, I started attending a local (Rochester) meditation group and what I learned really helped me through this illness time and in developing an overall healthy happy outlook.

I agree it's really a tough decision. I also have Stage 1 IDC with the same treatment: surgery & radiation only. . When I asked my oncologist point blank about the re-occurrence rate. She seemed evasive but said this drug lowers re-occurrence by 50% (of whatever percentage I have). She was evasive on the % I have of re-occurrence. Anastrozole (I've only been on it for 10 months) is aggravating my arthritis - not fun. She also said because my tumor was ER+ my re-occurrence rate will NEVER be 0. That bothered me for some weeks, but now I have accepted that fact. I refuse to live in fear - but still wonder if the drugs help that much. I found this calculator to be of great interest. Someone posted this a while back. https://www.breastcancer.org/research-news/online-tool-predicts-hr-pos-recurrence-risk https://www.cts5-calculator.com/

Thank-you so much for sharing that link Kathy! It shows I have a reoccurrence risk of 4%! If that calculator is accurate, then taking an AI for 5 years with a 50% risk reduction would be only a 2% difference. Not worth the risk in my view. I will include this in discussion with my new oncologist.

Ah, I just read the fine print and this tool is for use after a woman has taken an AI or Tamoxifen for 5 years. This calculator then helps the doctor decide if the woman should continue the drug or not. I'm disappointed that the studies supporting this tool did not include a control group of women who did not take the drugs.

Let me know what the doctor says. Keep in mind if it does come back - it will probably come back in the brain, bones, lung or as liver cancer, That's what I keep in mind.

On another note - I went to a cancer talk on 9/12. It was really interesting – they had a panel of 6 doctors, to talk about re-occurrence.

The most interesting fact was that even people with a bi-lateral mastectomy, have the same rate of re-occurrence, as those that had other treatments. Because some breast tissue is left behind even < 2%, so this does not change the re-occurrence factor. They said they are trying to talk most women out of this for that reason. I learned a lot of stuff there.

And that is why I did not have a mastectomy - same risk of reoccurence.