Sorry to hear about the delay x
Just a quick update - so I am on another week break possibly two until the ALT returns to a normal level and will then continue on 400mg. Hopefully that will be a more manageable dose for the poor old liver 
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So glad Iāve found this thread. Iām being recommended ribociclib but am very concerned about the impact on blood count as I have a family history of blood disorders (my dad had aplastic anaemia) and am also concerned re the impact on your liver as my lfts have been allover the place since my surgery in January (never an issue before)
Iām not having chemo (after having the oncotype dx test) and am about to start radiotherapy next week. It feels like ribociclib might be like chemo but for 3 years, which really puts me off despite the benefits in reducing recurrence risk.
Will be having an in depth discussion with my oncologist after radiotherapy but interested if anyone has considered ribociclib and decided not to take it?? Also with Bupa do you have to get pre-authorisation for every cycle (I havent had good experience with Bupa since I was diagnosed)??
Re insurance, the oncologist should request for each cycle. The insurance company does approve cycle by cycle.
I am only on my first cycle so do not yet know the full impact on my blood counts - so far OK, but that could all change and Iāll then reevaluate.
I see it as diluted chemo spread over three years. If I can manage I will continue to take - I see us as being lucky as women in our position a couple of years ago didnāt have this opportunity. Also due to the NHS delay some women will be out of time to get this. However the gap since last treatment is longer for Ribociclib than Abemaciclib so hopefully more will come within the 12 month limit.
Letrozole for me has been worse, but Iām now on the brand Femara so going to see if thatās better.
I canāt remember the improved stats for taking both of these on recurrance, but theyāre not really that significant. The most significant is surgery. We could be taking these and they make no difference. Who knows 
Ribociclib is incredibly expensive and I think costs the NHS close to Ā£3k per month plus tests and monitoring.
Your oncologist is the best to advise of course but itās worth checking in to see how everyone fares on this. Iāll post my bloods for the next few cycles but we are all different of course.
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