Looking for research re: taking AI drugs vs not taking them

Alternative dosing regimen for exemestane
https://jamanetwork.com/journals/jamaoncology/fullarticle/2802824 NB: although estrogen was lowered, study did not look at tumor outcomes, e.g. metastases, local recurrences, etc. on alternative dosing. In other words, the higher dose may be doing more than just lowering estrogen--and whatever that "more" is, is what's preventing the cancer from coming back. BTW, I'm neither an MD nor a scientist.

Alternative dosing regimen for letrozole
https://pubmed.ncbi.nlm.nih.gov/26667449/ Same caveat as exemestane study.

Alternative dosing regimen for tamoxifen
https://pmc.ncbi.nlm.nih.gov/articles/PMC11101371/ Not sure if tumor recurrence was the same as with full dose.

I've never found an equivalent study for anastrozole

Also, if I have misunderstood any these studies, please correct me!

I've always been told that if a woman is past menopause, she will go on an Aromatase Inhibitor, not Tamoxifen. So I'm wondering if there's a reason that your doc wants you on Tamoxifen? Maybe it's because of side effects and other medical conditions?

Thanks for posting.

I had that popping and eventually pain about 20 years ago, from my Osteoarthritis. The Thumb Orthopedist said I didn't need surgery, it was a slipping joint, and just to wear a special thumb splint every night to bed, to hold it in the proper position. During the day if you need it. I'm still wearing it only at night & never needed surgery! Go on Amazon and enter in the search bar: "Comfort Cool Thumb CMC Restriction Splint." Not that expensive. Hope it works for you!

Thank you for the suggestion. Will try it

You sound almost identical to me. I did chemo radiation and surgery and am on my 3rd AI also. It being, Exemestane. I'm supposed to take it daily, but have decided to take it every other day. It does mess with your emotions and my memory is awful. I've been on this for a couple years now and would like to stop. I have osteopenia, but had that before the cancer hit. Hope everything turns out well for you. Please keep me posted!

So thankful you posted! I’ve become quite impatient lately with my inability to focus and remember. So much so that I “declared” I was taking the next month OFF, to see if I felt different. I have not received good feedback in this from my Nurse Sister-in-Law! Do you know the % or Stats we are dealing with? Why, really put ourselves through this?(other than the obvious—no more cancer!) I’m 71, and have just finally retired. I’m seeking solid numbers to persuade me to make the best decision!

I was on a anastrozole for six months. Every bone in my body hurt I couldn’t focus. I was a mess. I went off and taking my chances. I go back Mid summer for another mammogram. Fingers crossed that I will be OK.🙏🏻 best of luck to everyone. It’s a very difficult decision.

I had a lumpectomy at 79, chemo and radiation 5 days a week for 6 weeks because I had some lymph node involvement. I refused AI drugs. I recently saw my oncologist for my every 6 month check up and my blood wok showed no return of the cancer. I am now 83. My GP was amazed when he did my latest EKG and said my heart is perfect. I just returned from a trip to Cancun with my family. I had a wonderful time and I haven't gone through any hell like I did with my emotions in menopause, which is why I refused AI.

According to Google: “Tamoxifen was approved by the Food and Drug Administration (FDA) in the United States on December 31, 1977, for the treatment of advanced breast cancer. It was subsequently approved for the prevention of breast cancer in high-risk women in 1998. ...The third-generation aromatase inhibitors (letrozole, anastrozole, and exemestane) were approved in the late 1990s for estrogen-dependent postmenopausal breast cancer.”

I assume that the scientific studies that led to approval were done before 1998—in other words, almost 30 years ago. Perhaps your public library’s reference desk can help you search scientific journals for the studies that led to approval.

As best I can tell, prescribing AIs is considered “standard of care”. I’m guessing that by today’s standards it would be unethical to have a research study where one group got standard of care and another group got nothing. This video is 5+ years old, but I've never found anything better. It discusses how much each treatment (surgery, radiotherapy, AIs) reduces risk of recurrence.