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    lujos asked a questionBreast Cancer

    Aromatase inhibitor or tamox for recurrence?

    12 answers
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      lujos

      ChicagoSandy, thanks for the reply! I did research on natural hormone blockers after I posted and came to the same conclusion!

      This cancer is quite different from the first. First was 30mm, grade 3, in 2 sentinel nodes, HER-, very strongly ER/PR positive, ki67 20+. Treated with lumpectomy, chemo, rads.

      This one is grade 1, 15mm, HER-, ER+, unknown on every other measurement, as it’s a different hospital in a different country, where path reports are less complete. Has travelled further up the node chain, as a node clearance showed 4/11 affected.

      So I’m confused! I’m usually really good at research, but the info on recurrence treatment is sparse, and this new progression is confusing.

      10 months ago
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      ChicagoSandy

      1.5cm (15mm) is more promising than 3cm. It's also Grade 1, ER+ & HER2-, so it's much less aggressive. The 4 positive nodes fall outside the criteria for OncotypeDX, but you should definitely get a Mammaprint or Prosigna to determine low-vs-high (no "intermediate") risk. If it's Grade 1, you're almost certainly "low-risk" on either of those tests. As to the nodes, were they radiated last time out? If not, that's probably what they'd do. They might also switch aromatase inhibitors--anastrozole or exemestane. (Ibrance, Verzenio, or the other oral chemos are given only for metastatic--which yours is not--unless there's a trial going on and you qualify & want to participate). Also depends on your age--this time surgery & radiation might be the only thing they do, if you've developed a new ER+ tumor despite being on an AI.

      10 months ago
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      lujos

      Update for y’all, and especially for ChicagoSandy! Turns out it was a grade 2 after all, with 7 positive nodes. Not a primary tumour. They don’t do all the specialist testing here in the UK, but my oncologist says I have a pretty likely chance of recurrence/spread, as it came back hard after only 4 years.

      I had surgery, node clearance, then capecitabine. Now starting exemestane, but I feel if the side effects are too bad, I’ll stop.

      3 months ago