Letrozole and checking estrogen levels

Hi I’m new here. I’m 71 female with DCIS spot on my left breast. Supposedly my spot is ER+ so my oncologist started me on letrozole. Seems like we are putting out a match with the wind of a tornado. Estradiol level was 19 as post menopausal level would be. I doubt a more stringent test was performed for estradiol level. The stage of my spot is ZERO per biopsy. The spot is so small I suspect the actual biopsy removed the entire spot.

I have an uneasy feeling of this entire protocol. In the beginning I remember the tech doing my mammogram and she actually did not fully place my left breast on the shelf of the machine. It was a sloppy test in my opinion. And of course that is the supposedly side of the my spot of cancer. Im not at a facility recognized by NIH as cancer treatment center. I’m very very Leary of taking letrozole and told my oncologist with my health condition this medicine seems to be counter intuitive for life sustaining care. He said there’s no issue with heart nor chance of blood clot. I’m heading out for second opinion.

@mazingrace just fyi, letrozole addresses estradiol produced in the adrenals for those of us who are post-menopausal. I don't know but it seems logical to think that if estradiol was sufficient to feed a tumor, it is sufficient to require meds- depending on stage, genomic factors as interpreted by your doctor.

Are you having an Oncotype DCIS? That would tell you your risk, I believe and might be helpful for decisions. It can sometimes be done with biopsy but better to do it after surgery, I believe. Are you having a lumpectomy? Radiation?

Are you concerned that the mammogram might have missed something? Can you have an MRI? Sorry for all the questions!

Hello. You're right to be perplexed as you struggle for acceptance of your findings on the mammogram. A second opinion and maybe an additional test like a contrast mammogram could be a step in the right direction for peace of mind. I'm a newly at taking letrozole myself. What happened w my body's reaction to it is very encouraging to me. In the month between the biopsy (and finding the biology of the cancer to be ER+) and the lumpectomy, the cells of the cancer already showed a positive response. I'm encouraged to continue it. My baseline lipid panel and dexa scan will help us monitor any neg effects on these issues and I'll work w the oncologist if things come up. Peace on your fact finding.

How were they able to determine that your cells showed a positive response?

Estrogen is feeding this cancer. I was stage 3 with a physically measurable lump. I went on Letrozole before surgery and chemo, and my oncologist used calipers to measure the tumor monthly as it appeared to shrink. After 7 months I had a lumpectomy where they did discover dead cancer cells (alas, not enough). I resumed AI's after chemo/radiation and will complete/terminate Letrozole's 5 year plan on New Year's eve this year. Because of lymph node involvement I have a 25% chance the cancer will return, but as my oncologist was quick to point out it's a 75% chance it won't. I will be 70 in two months.

In my situation it was the examination of the tumor cells by the pathologist and noting physical changes in them compared to the biopsy sample. After only a month on letrozole I was impressed. And, grateful.

These posts are great. I think it is so helpful for us to hear evidence of how effective an AI really is. Taking a pill daily seems so simple that I sometimes felt I wasn't doing enough!

You and me both. I sometimes forget I'm still "treating" the breast cancer because I don't notice it. It is good to remember, and I'm grateful.

I’m stage ZERO and have absolutely no measure of even the tinniest of lump to be felt. I had (obviously) NO LYMPH INVOLVEMENT.

I assumed it was since the doc ordered letrozol. I know.. ask the doc next time! But you have asked a very good question. Good point to clarify.