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Feb 15, 2019 11:49AM
Feb 15, 2019 12:06PM
After 10 years of nonstop Arimidex/anastrozole, my med onc declared me "done" with AI's last May.
Her plan for me was subject to revision all along. At the very beginning, she said she recommended an AI rather than tamoxifen in my case because I was firmly menopausal and she didn't like the risks associated with tamox. A baseline DEXA bone scan indicated I was already osteopenic; but she wasn't concerned about that (yet). In her words, osteoporosis was treatable; uterine cancer, not so much.
Three years later, she said she was waiting for results of the "extended AI" trials, which would help us decide whether I should stay on an AI longer than 5 years (the standard at the time). Trial results still weren't available at my 5-year mark, but my bone density was stable and my other SE's were minimal, so we decided to split the difference and go for 7 years.
By the time I'd been on anastrozole for 7 years, she was leaning toward the full 10. She said if I'd been "low risk," we'd have stopped at 5 years; but I wasn't. (My Oncotype DX score was 26.) My bone density had slipped a little, but I was still above the osteoporosis threshold.
So, when she walked into the exam room at my recheck last May, she announced, "I'm writing orders to discontinue the Arimidex." We had talked about BCI testing the previous year, but only hypothetically. For me, it was a moot issue by then. (Honestly, I really didn't want to know at that point.)
The very good news is that I had my biennial DEXA bone scan in conjunction with that med onc visit, and I haven't lost any more bone. In fact, the bone density in my lumbar spine (which was consistently the worst) had *increased* a bit, so they did a wrist/forearm scan to double-check. I have not been on a bisphosphonate or Prolia -- just Vitamin D3.
All of that was pretty much ratified by the recent recommendations from ASCO regarding 10 years of AI:
Edited to add: Chris13, I think your conclusion about that study is correct. Here's the key statement:
"What these study results demonstrate is that, in contrast to the beneficial effects of anastrozole on breast cancer recurrence which extend substantially beyond the cessation of treatment, anastrozole-associated BMD loss begins to resolve immediately after treatment cessation and any bone loss associated with anastrozole can be monitored and managed as needed."
2008, IDC, Stage IA, Grade 2, 0/3 nodes, ER+/PR-, HER2-