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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Breast Cancer

hello i was wondering if i need to take Arimidex . i am turning 50 this year i got breast cancer in January 2012 which was a loblyer carsnoma i had a double mastectomy and chemo, i have just had a hysterectomy last Thursday were they took everything. i was on tamoxifen from November 2012 until 8 January 2015. i had a lot of side affects. i also have a 6 year old son that i still need to raise as well. i am really condensed about the side affects and i want a normal life with out pain so i can be a great mother.

Thu, 27 Oct 2016
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Oncologist 's  Response
Hello and welcome to HCM.
The most important issue that has to be considered before recommending Arimidex is menopausal status. Arimidex benefits only patients who are menopausal and with your age can be defined as as:
1. Having Prior Bilateral oophorectomy (This means they took your ovaries with your hysterectomy)
2. Less than 60 years old and have not have a menstrual period for more than 12 months in the absence of treatment with chemotherapy, tamoxifen, or ovarian suppression medication. (I see you stopped taking tamoxifen on January 2015).
3. If you are taking tamoxifen again, then estrogen levels have to be in postmenopausal ranges

If you are in any of this categories then you are postmenopausal and definitely patients who have had Estrogen Receptor Positive breast cancer and are postmenopausual benefit from exposure to Arimidex at some point (After breast cancer or after some years of taking tamoxifen). Arimidex lowers the risk of the disease coming back.

However there are some issues:
1.As you may have been told by your oncologist. Hormonal treatment with tamoxifen has to be taken for 5 years to get a benefit from it (you only took it from Nov 2012 to Jan 2015)
2. There is numerous clinical trials that have shown that switching the treatment of patients after 2 to 3 years of tamoxifen to Arimidex, decreases the risk of cancer coming back, however in this studies patients DID NOT discontinue tamoxifen or had stopped it for less than one year before starting arimidex.

In conclusion, no clinical trial can answer a case like your where you suspended tamoxifen for almost two years, however if you are postmenopausal then you may have a benefit of exposure to Arimidex so I will recommend for you to take it (of course with an evaluation by your oncologist and a bone densitometry). Most women tolerate this type of medications really well.
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Suggest Treatment For Breast Cancer

Hello and welcome to HCM. The most important issue that has to be considered before recommending Arimidex is menopausal status. Arimidex benefits only patients who are menopausal and with your age can be defined as as: 1. Having Prior Bilateral oophorectomy (This means they took your ovaries with your hysterectomy) 2. Less than 60 years old and have not have a menstrual period for more than 12 months in the absence of treatment with chemotherapy, tamoxifen, or ovarian suppression medication. (I see you stopped taking tamoxifen on January 2015). 3. If you are taking tamoxifen again, then estrogen levels have to be in postmenopausal ranges If you are in any of this categories then you are postmenopausal and definitely patients who have had Estrogen Receptor Positive breast cancer and are postmenopausual benefit from exposure to Arimidex at some point (After breast cancer or after some years of taking tamoxifen). Arimidex lowers the risk of the disease coming back. However there are some issues: 1.As you may have been told by your oncologist. Hormonal treatment with tamoxifen has to be taken for 5 years to get a benefit from it (you only took it from Nov 2012 to Jan 2015) 2. There is numerous clinical trials that have shown that switching the treatment of patients after 2 to 3 years of tamoxifen to Arimidex, decreases the risk of cancer coming back, however in this studies patients DID NOT discontinue tamoxifen or had stopped it for less than one year before starting arimidex. In conclusion, no clinical trial can answer a case like your where you suspended tamoxifen for almost two years, however if you are postmenopausal then you may have a benefit of exposure to Arimidex so I will recommend for you to take it (of course with an evaluation by your oncologist and a bone densitometry). Most women tolerate this type of medications really well.