Aromatase Inhibitor

[nohorn]

I may be put on a aromtase inhibitor (hormone therapy) for a e/p marker breast tumor, along with radiation. I need to choose between that treatment and a bilateral masectomy. The aromtase inhibitor has horrible side effects such as bone loss and joint pain and I would take it for 5 years. It seems to me that the bilateral masectomy would be the wiser treatment. I know that the treatment depends on the individual. I am 75 y.o. and probably have some bone loss naturally already.

I think bone loss would alter my remaining years as far as quality of life is concerned. Am I right in thinking the bilateral masectomy would be a better choice. I would not have to undergo radiation and aromatase inhibitor treatment if I have a masectom.

(very small breast tumor, Stage one) I have had one dysplasia in the other breast a few years ago.) Please advise squad and others, all will be appreciated.

[anneasquith]

im not a doctor, but if it were me I think id go for the mastectomy.

[237SJ]

It`s not the drug as such that causes bone loss. It`s the depletion in the body`s estrogen that can cause bone loss. IMO that might have long term implications in a younger person but in someone who is a bit older, there would already be post-menopausal bone loss anyway. Calcium and vitamin D supplements could counteract that. Some aromatase inhibitors such as anstrozle (Arimidex) have been shown to not only counteract the effects of estrogen in breast cancer, but prevent recurrence and there is a school of thought that says that it is a good idea to stay on them beyond the 5 years. Tamoxifen can cause joint pain in some people but then again, it doesn`t in all people. All drugs have side effects and you may get some or none of them.

[wolf63]

The mastectomy option would be what I would choose. I suppose you need statistical information to enable you to make a decision.

[237SJ]

*anastrozle* (one day I`ll learn not to make typos.

[237SJ]

BTW - nobody on here can really answer your question. Don`t be put off by the drugs though - they are not that bad. You need to speak to your oncologist as no two people are the same. You could get some answers by signing up to breastcancercare.org They are very good but I would get some answers from the oncologist first.

[nohorn]

Yes I have devouring the internet on breast cancer treatment. I really appreciate the response. To complicate the problem I have been on hormone replacement therapy for many years and I have to go off cold turkey. I am curious on how many responses woud do masectomy if it were them. I have to weigh everything carefully. I am seeing an oncologist and radiologist. Anastrozole is the drug that they are talking about. I am trying to absorb a lot of information quickly. Answer banks sure helps!

[anneasquith]

nohorn, whatever choice you make, good luck and take care .

[nohorn]

Thank you to all of you... Ah...... life can get complicated

[Sqad]

Hi nohorn.

Let's "cut to the chase" here, assuming that you have a Stage 1 breast cancer and whether it is treated by surgery/DXT or therapeutic measures, the 5 year survival rate is almost 100%, so lifespan is not an issue.

Mastectomy/DXT or lumpectomy/DXT is a well established and popular choice, but as 237SJ mentioned, the side effects of drugs may not be a problem, although, they are significant.

You are 75 years of age and I presume you have no history of heart attacks, strokes or high blood pressure, as the latter may mitigate against choosing Hormone Therapy, and surgery, although has issues, would not be a problem for you.

If you were a relative of mine seeking my advice, i would suggest mastectomy/lumpectomy followed by DXT.

Remember, my advice may be biased.......ask a surgeon a medical question and you will get a surgical answer ;-)..........discuss it with the Oncologist and Radiotherapist............but you will have the final say.

[Sqad]

nohorn........a question from me........"Why do you want a bilateral mastectomy?"

[anneasquith]

sqad,,,,,,I hardly think the lady WANTS a bilateral mastectomy.

[237SJ]

Maybe because there has been dysplasia on the other side and the OP is thinking that there could be a tendency for something to happen on that side in the future.
Why masectomy and not lumpectomy though? Seems a bit drastic. If I was in your situation, I`d opt for lumpectomy, radiotherapy and Arimidex. That`s just me though. Arimidex is a good drug. There are more statistics about Tamoxifen because more people have used it and for longer. I was told by my Mum`s oncology team that they think staying on Arimidex for life is a good preventative measure against recurrence and new cancers of the breast. BTW - I don`t think it gives as much joint pain as Tamoxifen (my Mum didn `t have any) and they can do DEXA scans to keep an eye on any bone thinning. If you`ve been on HRT, you might have more bone density to start with anyway.

[Sqad]

237SJ

\\\\\Maybe because there has been dysplasia on the other side and the OP is thinking that there could be a tendency for something to happen on that side in the future.
Why masectomy and not lumpectomy though? Seems a bit drastic. If I was in your situation, I`d opt for lumpectomy, radiotherapy and Arimidex.\\\

Seems reasonable.

[nohorn]

Hi Squad: Yes it is stage one, I had a lumpectomy last week. It is nearly healed up. The other breast had a dysplasa insitu. Now my worry is if the aromtase inhibitor knocks off my estrogen (what there is left of it at my age) and progesteron, will it turn me into a vegatative old lady. One needs those hormones, like for your thyroid and adrenal glands.

I had to go off my bioidentical hormone replacement cold turkey, not fun.

Thanks squad and others; you are a godsend.

[nohorn]

I thought I would add, the surgeon wonders why I want such a radical approach. I guess I could take a masectomy at my age now a lot easier than in the future if somethings pops up in breast.

[nohorn]

I meant to say "the other breast."

[JamesBlack]

You can treat your breast cancer with the help of breast balloon brachytherapy or hormone therapy to cure the cancer. This treatments might not provide you any radiation side effects(http://www.advancedradiationcenters.com/cancers/breast-cancer/) hopefully.