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Should I Switch Raloxifene To Tamoxifen For Breast Cancer?
Question: I would like to ask Dr Ajith Puthillath along with Dr Oana:
I am almost 59 yrs old and dx with breast ca at age 50 (premenopausal but menopause from chemo), er pr positive with 3 small nodes. Had partial mastectomy, chemo, and radiation. Tamoxifen for 4 years, Arimidex for 2 years. Have been w/o hormonal rx for 2-3 years.
Now with the new info about tamoxifen, should I consider starting a few more years of tamoxifen or would Raloxifene be OK (I have osteoporosis). My oncologist was unsure but said Tamoxifen is OK if I want to and she prefers over Raloxifene. I prefer Raloxifene since it would address both problems.
I am otherwise healthy except for skin cancers. My mother was the first in our family know to have breast ca and died from metastatic about 10 yrs after dx and similar rx to me and dx at later age.
She took DES when preg with me.
I know the recent studies are on Tamoxifen but would not Raloxifene perform similarly?
I am not concerned about minor side effects; I don't want to get recurrent cancer!
Thank you.
XXXXXX
I am almost 59 yrs old and dx with breast ca at age 50 (premenopausal but menopause from chemo), er pr positive with 3 small nodes. Had partial mastectomy, chemo, and radiation. Tamoxifen for 4 years, Arimidex for 2 years. Have been w/o hormonal rx for 2-3 years.
Now with the new info about tamoxifen, should I consider starting a few more years of tamoxifen or would Raloxifene be OK (I have osteoporosis). My oncologist was unsure but said Tamoxifen is OK if I want to and she prefers over Raloxifene. I prefer Raloxifene since it would address both problems.
I am otherwise healthy except for skin cancers. My mother was the first in our family know to have breast ca and died from metastatic about 10 yrs after dx and similar rx to me and dx at later age.
She took DES when preg with me.
I know the recent studies are on Tamoxifen but would not Raloxifene perform similarly?
I am not concerned about minor side effects; I don't want to get recurrent cancer!
Thank you.
XXXXXX
Brief Answer:
Please refer below
Detailed Answer:
Hi
Thanks for your query.
I understand your concern. The recent data on 10 years versus 5 years tamoxifen is indeed promising. But all the patients on the 10 year arm took tam continuously. We have no information regarding intermittent tam so far from any studies. Since you have taken hormonal treatment for six years and off it for 2-3 years, there is no data on the basis of which I can recommend you to restart it again. This is in general for endocrine therapy, whether tam or raloxifene or arimidex.
Now say if you start taking it any way for whatever benefit it has, the question is what is the harm?
Tamoxifen can cause uterine problems including cancer (1/100 chance) but raloxifene not likely to do so. In fact it can lower the risk. And as you said you are not bothered about the minor side effects.
So the bottom line is that though we do not recommend raloxifene for a scenario like your at this point, it can still be considered for an individual patient who is concerned about disease recurrence and not so about the minor side effects.
Hope I have answered your query. I will be available to answer further followup queries, if any.
Please refer below
Detailed Answer:
Hi
Thanks for your query.
I understand your concern. The recent data on 10 years versus 5 years tamoxifen is indeed promising. But all the patients on the 10 year arm took tam continuously. We have no information regarding intermittent tam so far from any studies. Since you have taken hormonal treatment for six years and off it for 2-3 years, there is no data on the basis of which I can recommend you to restart it again. This is in general for endocrine therapy, whether tam or raloxifene or arimidex.
Now say if you start taking it any way for whatever benefit it has, the question is what is the harm?
Tamoxifen can cause uterine problems including cancer (1/100 chance) but raloxifene not likely to do so. In fact it can lower the risk. And as you said you are not bothered about the minor side effects.
So the bottom line is that though we do not recommend raloxifene for a scenario like your at this point, it can still be considered for an individual patient who is concerned about disease recurrence and not so about the minor side effects.
Hope I have answered your query. I will be available to answer further followup queries, if any.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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