Thoughts on not taking Anastrozole for a 75 year old woman and 0 oncotype
My stepmom was recently diagnosed with early stage ER+/PR+ (HER2-) BC and had a lumpectomy and radiation. She already has a lot of the side effects from Anastrozole from her age and other issues, and while I know it's her decision with her doctor, I am wondering if anyone has opted out of taking it. Her oncotype score was 0 and the margin of recurrance (she's told) is 3% vs. 5%.
Any insight is welcome - thank you!
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Oncotype 0? Wow! I would suggest she talk to her PCP (not just oncologist) about the risk v benefit analysis of an AI in those over 70. I took Letrozole for 6-1/3 years, stopping at just past 72—my onc said the bulk of the benefit occurs in the first 5 years, perhaps the first 3. How's her cardiovascular risk (has she done a coronary-calcium CT)? Has she had s DEXA scan for bone density? (Does she already have osteopenia or osteoporosis)? Those are considerations in deciding whether induced estrogen reduction might cause more harm than good in seniors.
Most Luminal A breast cancers (like hers & mine), if they recur at all, recur 10-30 years out. If hers was Grade 1, semiannual surveillance (mammograms/ultrasounds/MO visits) might be an option.
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I had stage 1 breast cancer when I was 68, with an oncotype of 17. I opted for Tamoxifen since I'd had a hysterectomy 10 years earlier. I stopped taking it after about 9 months - it was affecting my personality and I'd developed a fatty liver. So, I haven't taken anything since 2019. I'm doing fine, and I have no reason to regret my decision.
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I'm 72, In had oncotype of 19 and LCIS (pre-cancerous, not actually cancerous as tr name implies) in the opposite breast from the one I just had surgery on. I'm going to try tamoxifen and see how it goes. If I didn't have the LCIS (which they found from sending tissues from the bilateral breast reduction which was the reoncstruction option I chose) , I don't think I would do any of the neds currently available. Especially with oncotype of 0! Very best wishes to your step-mom.
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thanks everyone!
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