I am no expert but at the moment I too am only on letrozole…have been since dx about 13 months ago. Though that may change. Everything depends on your status…er+ve, HER2+ve or -ve, etc. My primary was 14 years ago. I was ER+ve 8/8 so put on letrozole immediately. My secondaries are in my bones, so also have denosumab injections as a bone strengthener. I had lung spots originally, but they disappeared after 3 months on letrozole. Haven’t come back as of last scan in Nov. I also have a patch on my chest in the skin, which is getting a bit bigger, so my drugs may change, possibly to tamoxifen my onc said. I was originally HER2+ve so nearly went onto chemo for that, but I was fit and well so onc delayed. Just as well as the skin biopsy last Nov, showing the patch was indeed skin mets, was HER2-ve. So still just on letrozole.
The thing is that everyone is different, and you certainly can just be on a hormone drug alone if it is working. Do you know your oestorgen status? 4/8? 8/8? They may first try other hormone drugs before launching you onto chemos unnecessarily. It all depends on how you are in yourself, and what your secondary is sensitive to.
I have learnt that the primary tumour may not be removed once secondary is diagnosed. It won’t help overall if the cancer has already spread, so it will be treated with the drugs you are on rather than with surgery. If your primary has reduced then the onc will assume that letrozole is working. Also he will assume the lung spots are breast cancer secondaries because that is the most likely, as you have breast cancer. He will watch to see if they shrink. If they are stable then he will be satisfied with that too. Do you have regular scans? They will look carefully at those.
Another thing is that they like to hold treatments back and not use everything up straight away. So again he will stick to the letrozole if it seems to work. The cancer can adjust to drugs, so they don’t like to use them up. One at a time really. There are chemos and other treatments for the future, if needed.
See how it goes. Letrozole can be a powerful drug on its own. And it is an obvious first step. Stable is as good as shrinking. Your lung spots are stable you said. i know how hard it is to fathom all this. I knew nothing at the beginning and am still learning. My skin is my worry at the moment. He says my bones are stable.
Hope that helps a bit. It is so hard to know what is going on, don’t you think? Look around for older threads on letrozole. There are a few. look down the list. Take care.
I was diagnosed in Sept 2010 with primary and secondary at the same time, multiple small lung mets in both lungs. I was on letrozole for 4 years and during that time they completely disappeared! The letrozole stopped working after 4 years and I have had various treatments since then! I did have a lumpectomy to remove the primary in 2010 as the mets weren’t discovered until after the surgery (but within a month!)
Letrozole works well and is a very easy treatment! Hopefully it works for a long time for you!
Good luck, Glo xx