Told to quite endocrine therapy for Diep

kaynotrealname

My surgeon told me that I needed to go off letrozole for two weeks before and two weeks after my DIEP. I had a hormone positive tumor though and am not very comfortable with that. I was told it was because letrozole increases your chances of blood clots. Is that the standard protocol?

dancemom

I am 2 weeks out from diep- I was told to stop letrozole for 2 weeks prior, but they started me back on it during my hospital stay. I also was told to stop all caffeine 2 weeks before (I weaned myself off slowly over 3 earlier weeks) and am not to have any including chocolate for a month after surgery. For clots, I am on baby aspirin and was told to get up and walk a lot.

ratherbesailing

I don't think stopping letrozole for a couple of weeks will do any harm. Some of it stays in your system for about a week after you stop, and many women end up taking breaks longer than that. A clot could compromise the success of your DIEP operation. If you're worried, perhaps you could reach out to your medical oncologist?

kaynotrealname

Thank you both so much for chiming in! I spoke with both my oncologist and surgeon about my concerns and my oncologist does feel that one week before and one week after would be preferable but she'll go with whatever my surgeon recommends. When I mentioned my concerns to him he said it would be up to me considering my feelings towards risk. If I wanted to do only one week before he'd do it but it's risky and I don't have nearly as much protection from clots. He said instead he could do two weeks before and then send me home with a blood thinner after surgery so I could start my endocrine therapy right afterwards and that's the solution I jumped on. It seems like the best balance. I can't tolerate aspirin though so it'll have to be something else but I'm sure there's an alternative.

sondraf

I had this done last year and came off Ibrance but stayed on letrozole throughout. Then again, I was also handed 12 daily anti-clot injections to do each day after surgery so perhaps that is how they balanced it out (also: stage IV so a little different). I had a short tidy up last Saturday and again, stayed on the letrozole but came off the main drug for a few days before and after and no one said anything about clot potential.

Thats interesting about caffeine, dancemom - I know they tell you to drink a bunch of water before blood draws and avoid caffeine ahead of that as dehydration can make the blood sluggish.