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Sep 1, 2018 03:24AM
Sep 1, 2018 04:20AM
TomMorrow, forgive me if I'm over-explaining or misunderstanding you.
Ovarian suppression and the AI's are two different (but closely related) things. OS is an injection, and the AI is a pill taken daily.
If your wife is already in menopause, she may not need to do OS at all, or an oophorectomy for that matter, and could take an AI alone.
Importantly though, being postmenopausal (whether naturally, surgically, or chemically) will NOT eliminate the need for AI's or tamoxifen, even though it might eliminate the need for OS.
Many of the side effects of OS and AI's overlap because both are depriving the body of estrogen, but in different ways. Your MO will be able to discuss the benefits of your wife doing nothing with her ovaries, vs. shutting them down with OS, vs. an oophorectomy. This can often be a bigger problem for very young women, since it's so unnatural to enter menopause in your 20s or 30s.
Your MO will likely monitor her estrogen levels to make sure she really is post-menopausal, because you're right that it can be a gray area.
Also, tamoxifen is different from the AI's in the sense that it can be taken by pre or postmenopausal women, so your wife may have that as an option regardless. AI's are the "big guns" though, so your MO might prefer those over tamoxifen.
I hope that helps and makes sense - it's nice that you're taking an active role in learning about your wife's treatment.
Initial diagnosis at 32 years old. Chest wall resection 18 months later due to skin metastasis, probably from needle seeding during initial biopsy. Skin graft from right thigh!
8/2016, IDC, Right, Stage IA, Grade 3, 0/2 nodes, ER+/PR+, HER2-
9/30/2016 Lumpectomy: Right; Lymph node removal: Sentinel
10/31/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
4/30/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
9/2017, IDC, Right, Grade 3, 2/5 nodes, ER+/PR+, HER2-
10/31/2017 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Tissue expander placement
1/2018, IDC, Right, Grade 3, 0/5 nodes, ER+/PR+, HER2-
4/30/2018 Lymph node removal: Right; Mastectomy
5/9/2018 External: Lymph nodes, Chest wall
6/30/2018 Zoladex (goserelin)
6/30/2018 Xeloda (capecitabine)
1/14/2019 Aromasin (exemestane)