Looking for advice re: hormone treatments
Hello - I am a 77 year old, post-menopausal woman and am new here. I was recently diagnosed with invasive lobular carcinoma of the breast. I've had multiple tests, including CT scans, MRI's, ultrasounds, biopsies, and an Oncotype DX Breast Recurrence test. I had a lumpectomy about a month ago. They removed a 23mm tumor from the right inner quadrant of my right breast. I had not been getting regular mammograms and the tumor was discovered when I broke some ribs.
According to the pathology reports, it was grade 1, all margins negative for invasive carcinoma, with no lymph node involvement. It was HR positive, HER 2 negative, with a K-67 score of 6%, which I believe is considered negative. My Oncotype DX recurrence score was 9, with a distance recurrence score of 3% and a group average absolute chemo benefit score of < 1%. I am scheduled to begin radiation treatments next week (15 treatments over 3 weeks).
Given my test results, my age, and the side effects, I am inclined to take a pass on hormone treatments. I found the "Predict" Breast Cancer tool on this website. It is from Cambridge University in the UK, so I assume it is as reliable as any prediction tool can be. When I entered my results, it basically indicated no benefit to hormone therapy. The 5 and 10 year survival rates with or without hormone treatments for someone my age and condition were basically identical.
I visited a medical oncologist last week and he was fairly insistent on hormone treatment. When I mentioned the side effects he said I should give it a try and he could switch meds if I had a bad reaction. He said if I lived this long with few if any medical issues I would probably live at least another 10 years. Honestly, at my age I'm more concerned with quality of life than longevity. I almost got the impression he was pushing hormone treatments (defensive medicine). Maybe I'm being unfair.
In addition to quality-of-life side effects like joint pain, hot flashes, etc., I understand that these drugs cause bone loss and death from injuries sustained from falls is one of the leading causes of death among seniors.
I would appreciate hearing from people in a similar situation and getting their opinions. Thanks for taking the time to read this.
Comments
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I understand your concerns over this class of drugs. Besides looking at potential side effects, understanding their frequency is a consideration as well. For instance, death from injuries sustained from falls, may be very low frequency (in my 13+ years here, I have not read of anyone experiencing this). Obviously, other se’s occur with greater frequency.
Trying the drugs and stopping if you’re having issues is a reasonable approach as is switching between drugs in the same class. Not taking a treatment is always an option and a valid one as long as one has no regrets if progression occurs. In the end, please do what’s best for you.0 -
As a retired pharmacist, I agree with exbrnxgirl’s approach.
You can certainly pursue regular bone density scans & consider bisphosphonate medication. Indeed, an IV option like Zometa for up to 3 years can provide strengthening especially since you’ve already had fractured ribs.
Keep in mind that lobular is a sneaky thing and actually can spread to unusual areas such as the GI tract. Monitor yourself for gut symptoms. Be sure to report anything which lasts longer than 2 months, as a general rule of thumb.
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