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Topic: Pre-surgery hormone therapy

Forum: Hormonal Therapy - Before, During, and After —

Risks and benefits, side effects, and costs of anti-estrogen medications. Note: Please remember that there are good experiences and bad with ALL treatments and this is a safe place to share YOUR experience, not to be influenced or influence others.

Posted on: Sep 24, 2020 03:08PM

TXLorelei wrote:

My oncologist has me doing six months of letrozole before a mastectomy and probably radiation. (I already know from the MRI and biopsy thatI have several positive nodes.) I know that taking that little pill is supposed to “starve” the cancer, but somehow I feel like I should be doing more. At first I wanted to do the surgery right away, just to get it over with!

In some weird way, I feel like I should be suffering more. All I have is hot flashes! I do think this is influenced by my memory of Mom’s chemo treatment 25-30 years ago.

Has anyone else played this waiting-for-physical-action game?

Dx 7/7/2020, ILC, Right, Grade 2, ER+/PR+, HER2- (FISH)
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Sep 24, 2020 04:48PM Beesie wrote:

What's your MO's reasoning for this?

Neoadjuvant (pre-surgery) chemo is often done for those with large tumors, or who are HER2+ or TN or sometimes, node positive. But letrozole before surgery? That's more unusual, although I believe some studies have suggested it shows promise as a treatment regimen instead of neoadjuvant chemo. Is your tumor large?

Why didn't you have surgery right away? I know there have been some delays because of Covid but you were diagnosed in July, and I thought most delays were done by then.



“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Sep 24, 2020 05:16PM LillyIsHere wrote:

Beesie, the breast center i go to has been doing the same, starting patients who qualify on anti-hormone therapy during Convid19 months to postpone the surgery for later on.

I am very curious to know if letrozole has shrinked your tumor TXlorelei. I hope so, that means that letrozole is working for you.

Dx 7/31/2019, ILC, Left, <1cm, Stage IIA, 2/5 nodes, ER+/PR-, HER2- Surgery 9/19/2019 Lymph node removal: Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 12/1/2019 Femara (letrozole)
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Sep 24, 2020 06:12PM - edited Sep 24, 2020 06:14PM by TXLorelei

The MRI showed one large and one small tumor totaling about 5 cm together

According to the MO, this recommendation was discussed with the care center's Tumor Board. She told me that doing this would hopefully eliminate the need for chemo. I expect that I'll have another biopsy in a month or so to see how it's working.

Dx 7/7/2020, ILC, Right, Grade 2, ER+/PR+, HER2- (FISH)
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Sep 24, 2020 09:02PM LillyIsHere wrote:

TXLorelei, how does MO know if letrozole is working? When are they going to have another MRI to check if the size of the tumor is shrinking? I don't want to scare you but I did have ILC. Before surgery, MRI didn't catch 2 positive lymph nodes and the LCIS in the other breast that were confirmed from biopsy after the DMX. ILC is not easy to be seeing with scans.

Dx 7/31/2019, ILC, Left, <1cm, Stage IIA, 2/5 nodes, ER+/PR-, HER2- Surgery 9/19/2019 Lymph node removal: Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 12/1/2019 Femara (letrozole)
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Sep 24, 2020 09:09PM Cowgirl13 wrote:

TX, I would definitely get a second opinion as soon as you can. Even if he discussed this at a tumor board meeting. When I was looking for a second opinion I was told that it is good to go outside because often the people who comprise the tumor board can tend to have the same outlook. Good luck.

Be the kind of woman that when your feet hit the floor each morning the Devil says: 'Oh crap! She's up! Dx 5/28/2009, IDC, Left, 2cm, Stage IIA, Grade 3, 0/4 nodes, ER+/PR+, HER2+ Surgery 6/18/2009 Chemotherapy 8/3/2009 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 12/21/2009 Hormonal Therapy 2/23/2010 Arimidex (anastrozole)
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Sep 24, 2020 09:26PM MinusTwo wrote:

Lorelei - If you don't mind my asking, you're in Houston so where are you going?

You have a plethora of medical institutions to choose for a 2nd opinion. Even if you're committed to staying in your area, it might be worth going to the med center &/or one of the research/teaching hospitals for a 2nd opinion. I didn't want to be a number in line at MD Anderson, but you certainly can get a 2nd opinion there. Or Methodist, or Baylor, or St. Luke's or Memorial. I was sure glad I got a 2nd opinion at the Med Center.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Sep 24, 2020 09:31PM OCDAmy wrote:

I had a large tumor and my MO tried to shrink it prior to surgery with AI. It reduced the size but not by much so I still ended up with MX andchemo after surgery but I have read some research that it can be quite effective in shrinking tumors.

Dx 2/2017, IDC, Left, 4cm, Stage IIB, Grade 2, 2/13 nodes, ER+/PR+, HER2- Surgery 11/14/2018 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting, Silicone implant Surgery Lymph node removal; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy Arimidex (anastrozole) Surgery Reconstruction (left): DIEP flap Radiation Therapy Whole-breast
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Sep 24, 2020 11:01PM TXLorelei wrote:

My next MO appointment is in a couple weeks so I’ll find out then how they’ll check my progress.
@MinusTwo - I'm already going to Baylor in the Med Center since I live inside the Loop. I feel like I'm in good hands.

I do know that my sister who is a pharmacist was completely unsurprised when I told her about the treatment plan. (She does drug education at a hospital in a different state.)

I’m just incredibly impatient. I had everything planned in my mind and I guess I still haven’t mentally reset all my expectations.

Dx 7/7/2020, ILC, Right, Grade 2, ER+/PR+, HER2- (FISH)
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Sep 25, 2020 01:51PM MinusTwo wrote:

Lorelei - Yup - you're in good hands at Baylor. Still, be sure you "click" with the docs you get. It's a long haul and you want someone you feel comfortable with who gives you all the time & information you deserve. If personalities don't match with one of the docs, don't be afraid to go for a 2nd opinion.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014

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