Ibrance and Letrozole: Newly Diagnosed Treatment

Maybe you could share this information on a new thread about oncotype testing. Maybe this current thread about using oncotype to decide on treatment could be expanded with all of this information.
https://connect.mayoclinic.org/discussion/oncotype-result/
Have you taken Ibrance and letrozole combo or another combo for metastatic breast cancer? What challenges have you had from this drug combination?

Make sure you ask if they are giving you the "Relative" percentage, or the "Absolute" percentage.

For my age group I have approximately (depending on the article you read) 6% chance of the cancer returning if I don't do the radiation and anti-hormone therapies. That means I have a 94% chance of it not returning.

If I take the therapies I have a 3% chance of the cancer returning. That means I would have a 97% chance that it would not return. These are the "Absolute" percentages.

My oncologist told me that if I took the therapies, it would improve my chances of not getting the cancer back by 50% -- because comparing 6% to 3% is a 50% reduction. That is the "Relative" percentage. But looking at the glass half full -- I have a 94% chance with no therapy and a 97% chance with the therapies and all their side effects. So my decision was no therapies.

Just a note that depending on what articles you research the numbers can change a bit, but you still need to be aware of the difference between the "Relative" and "Absolute" percentage values. Just FYI.

You have to be careful with looking at the percentages and know whether they are telling you the "absolute" percentage or the "relative" percentage. You need to ask that question.
For instance, in my age group, if I do not have radiation there is a 6% chance of me having the cancer return - which means there is a 94% chance it won't! That is the ABSOLUTE percentage. If I have the radiation it reduces the chance of me getting the cancer back to 3%.
Now when the oncologist was telling me about the anastrozole, she said if I took it, it would reduce my chances of getting the cancer back by 50% because if you compare the 6% chance to the 3% chance - that is a 50% reduction, but it is the RELATIVE percentage - in other words, 6% compared to 3%. BUT the absolute value is that without the anti-hormone therapy or radiation I had a 94 % chance of getting it back, and with the therapies, I had a 97% chance of getting it back. For a 3% chance, it was not worth it to me to brave the side effects.

I agree. I had a partial mastectomy in February and after researching all the info on the anti-estrogens and radiation, I decided not to take them because I did not want to live with the debilitating side effects. I am working with a Naturopath, doing the supplements, vitamins, veggie diet, exercise and taking Viscosan shots ( a derivative of mistletoe that has been used in Europe for over 30 years to fight cancer). So far I have no side effects except turning a bit orange from all the carrot juice! lol A number of good books out there, one is; Chris Beat Cancer. Gives a lot of information about the more natural treatments. I think it is a very personal decision and you need to do what you feel is right for you and what you believe will help. Good luck to all.

Since I'm trying (hard) to improve diet and at least make one of meals every day 100% plant based, did you feel any differently after switching to that eating plan? I've generally paid attention to nutrition, albeit casually so and have the world's worst sweet tooth, so I'm not expecting anything miraculous if I can follow a 100% organic, whole food/plant-based diet but I'm sure it can't hurt me. And I'm for anything that might better-help support the immune system.

I also am a volunteer in South Florida's Mounts Botanical Garden so am surrounded by people growing rare fruits and great vegetables. And the Hippocrates Institute, formerly headquartered in Boston, is nearby so I've heard a lot of stories of people getting serious about clean foods and, in many cases, also rebuilding health. [And I've seen family pets' health improved by careful nutrition. And can disregard any placebo effect to account for that.]

That last sentence of mine should read ..."the 'average risk of recurrence [for estrogen positive breast cancer] is currently thought to be REDUCED by ~45%, over 5 years, for women taking anti-hormone therapy."

I've been told by oncologists that the current thinking is that anti-hormone therapy can reduce the risk of loco-regional recurrence by an estimated 42-45%, which usually is called 50% for simplicity, over 5 years. That is a mean ("average") reduction. For someone with a personal high risk of recurrence, a 45% reduction is a big advantage for Team Anti-Hormone Therapy.

For someone with a very low risk, it's not as substantial. [My risk, IF the OncotypeDX test is valid, 'could' be reduced from 5% to 3% if I took the drugs. If anastrozole could reduce risk of recurrence to 0%, I'd have to reconsider not taking it.]

But my risk reduction from 5% to 3%, while a big 40% reduction, is only a small two percentage points.

I've seen doctors confuse percentage with percentage points so just want to clarify this point and restate that the "average" risk of recurrence is currently thought to be ~45% over 5 years for women with breast cancer taking anti-hormone therapy.

There is a lot of conversation here about the letrozole, but the Ibrance is part of this equation as well. This is a combination given to women who have metastatic breast cancer. The considerations of taking or not taking this combination is more than just considering the side effects from estrogen deprivation. The considerations I have used about treatments is the fact that I am younger than I would like, and yes I do consider quality of life but also some quantity. There are side effects to these drugs and the combination of drugs more than either one alone, but the alternative is a less appealing option.
How are you dealing with the MBC diagnosis? What are your motivations for taking this combination?

Rae, So sorry to hear about you suffering do much after lumpectomy.
Perhaps your lump was big and you have metastatic??
I did bilateral lumpectomy and refused chemo and rad, weighting
the side effects on body, on heart arrhythmia ,and possible prevention for reoccurrence.
I also have taking care of my late Alzheimer’s husband for 18 years .
Don’t have cancer history in the family.
Yes, stress is the huge factor for cancer shows up .
I am taking only Tamoxifen for er/pr positive as anti hormonal therapy.
And go holistic for immunity support. I do check the blood cells,
and don’t care about cancer reoccurrence for now.
Why should you go for radiation again? Are you on any med?
Take care !
And thank you for your post

My oncologist recommended the lumpectomy first, then I took Taxol during chemo , which laid me low until it was adjusted 20 percent lower, and the Herceptin. I'd do the Herceptin and radiation again, but not Taxol. Feeling so horribly sick (my daughter stayed with me 2 months and said she would walk into my bedroom to see if I was still alive) and watching all of my hair fall out was awful. My cancer showed up after 10 years of taking care of my husband who died with Parkinson's. That is another subject, but I wonder if stress had anything to do with it as I know of no one else in my family who had cancer.