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Should I not be taking hormone inhibitors after mastectomy?
I am 64. I was diagnosed DCIS Grade 3 and had mastectomy on Dec. 2024. Two lymph nodes removed, clear. ER+ 90% and PR-. On my visit two weeks after the surgery, my oncologist said I don’t need further treatment like taking hormone inhibitors ( endocrine therapy) like other ER positive patients do. He said the newest study shows the benefits of endocrine therapy is about the same as not having any. He said I can think about it. What should I do? Any of you have the same decision to make? Thank you very much!
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My thought is that AI not only prevents local recurrence but also reduces the risk of metastasis when the cancer cells depend strongly on estrogen. Lower the estrogen level should kill active rogue cancer cells that reside somewhere else? Metastasis in DCIS is rare, but did happen. So taking AI is not a bad idea when you can tolerate it. Then again some cancer cells can develop resistance to AI!
I read the article below and was surprised at the mention of metastasis in DCIS.
https://www.aacr.org/blog/2022/10/12/ductal-carcinoma-in-situ-the-weight-of-the-word-cancer/
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Hug
3 ReactionsThank you for the reply and for the link. I now want to talk to my doctor that I prefer to take meds.
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1 ReactionJust give it a chance especially your ER is 90%. If you don’t tolerate it well, you can drop it. Make sure you have base line DEXA before taking it. AIs can cause bone loss, Hugs
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1 Reaction@lindaloon these are potent drugs. I am pro-medication and took letrozole for my invasive grade 3 tumor. You have grade 3 DCIS and 90% ER which both argue for meds. However if I were you I would see if an Oncotype DCIS is being done so that you have full information on your particular cancer. The NCCN guidelines are not customized to your case, the way the Oncotype is. You need to look at risk vs benefit of the meds and the risk of recurrence. You could also get a second opinion.