I had a conversation with my general surgeon after he had done the op to take out the lymph nodes and he said to me that because I was 39, er and her2 positive and still having periods, that it might be worth considering taking a drug (cant’ remember the name of it) that would induce menopause (if chemo didn’t take me through menopause), so that I could have a different drug to tamoxifen with less side effects. I think he said these drugs are called aromatase inhibitors or something and that I would have a better time on them than tamoxifen. Having read all the scary stuff about tamoxifen I am wondering whether to suggest this course of action - although I’ve no children I have no real burning desire adn also, after chemo, a year of herceptin and 5 years of tamoxifen… well it’s hardly an option anyway. So I may as well go for thse post menopausal drugs. Has anyone else had this suggested ? Weird thing was, my consultant said that ‘if you were my wife, i’d definitel want you to do this’. When I mentioned this to oncologist he said he wouldn’t want to take away teh chances of me having children so wasn’t convinced. but just how possible are children away when faced with 5 years of drugs, taking me to 45!
I think it may be useful for you to call our helpline to help clarify the suggestions made by your surgeon regarding different treatment options and your concerns about your fertility, our helpline is open Mon -Fri 9am-5pm and Sat 9am-2pm on 0808 800 6000 and our specialist breast care nurses will be able to offer you advice, information and support.
In addition, you may find our booklet called ‘Younger women and breast cancer’ useful to read as it contains information about the issues concerning you, you can read this via the following link or request a copy from the helpline:
It will be interesting to see what others have to say on this one. My consultant and oncologist are both of the opinion that I should not have aromatase inhibitors (arimidex is one) until I am definitely post menopausal. As I was pre-menopausal when I was diagnosed I have been told I have no other option than to stick with tamoxifen for 5 years. I know some others on this site were pre-menopausal when diagnosed and are on arimidex but my consultant has made it very clear to me he would not want to consider aromatase inhibitors until he is certain that my whole body is post menopausal and not just partly post menopausal because of the chemo I have had.
I asked about drug therapy to stop my ovaries from working so I could have aromatase inhibitors rather than tamoxifen (I was 44 at dx) but I was advised not to - can’t now remember why. My onc intends me to be on tamoxifen for a couple of years and then swap to an aromatase inhibitor after that if I’m post-menopausal by then. I haven’t had a period since August - part way through chemo - so here’s hoping! I have read that this course of action is giving good results.
My chemo never stopped my periods, so much for the only plus side of chemo lol…and they didnt stop on tamoxifen either. I did have to have a total hysterectomy in october due to a large dodgy looking cyst…which thankfully turned out to be nothing (huge sigh of relief)…so got chucked into the menopause good and proper 3 days after the surgery. My booby doctor was stalking the ward corridors (and he does it so well lol) the weekend i was in hospital…saw me and hit the roof as nobody had informed him of me having to have a hysterectomy…so he came and had a chat with me…hes going to keep me on tamoxifen for two years (instead of 5) and then switch me over to something else for the remaining 3 years, which is fair doooos. He gave me a quick check up while i was lying there, which was cool (considering i wasnt technically his patient at the time lol), had a good old check of my new scar (am going to collect them) and then went stomping off to have a one way chat with the gynae surgeon…oooops. Funny old thing, I never saw the gynae surgeon after my op…but i saw my booby doc every day twice a day…wouldve loved to have been a fly on the wall on that conversation.
Bellatrix: Re: Tamoxifen v. Arimidex. There has been a comparative study (ATAC) following women with estrogen-positive breast cancer for over 5 years showing a relative advantage of Arimidex. The latter is an aromatase inhibitor i.e. it totally blocks the synthesis of estrogen rather than interferring with the action of estrogen. Arimidex is only prescribed to women who have ceased to have periods but chemotherapy seems to cause that pretty frequently. It certainly did for me after the first cycle of chemotherapy—though I was 52y. The main disadvantage of the aromatase inhibitors is that they reduce bone density making fractures marginally more likely than with tamoxifen. But I for one would risk that to make recurrence of my cancer less likely.
You have to be menopausal to have Arimidex. Just ceasing periods is not enough - sometimes that can just be a temporary side effect of the chemo and periods can return later. I believe there are blood tests to determine if you are really menopausal or not.
i queried whether i was truely menopausal, 54 years but prior to diagnosis had been on no bleed HRT, I had a FSH test which came back that i was post menopausal even though i had been on Arimidex 3 months, if in any doubt you can ask for one of these to put your mind at ease it is just a simple blood test and you get the results a week later.
I had Zoladex to stop my periods followed by ooperectomy last April. Switched from Tamoxifen to Exemestane immediately and in August had my second bone density scan. To my horror I was discovered to have osteoporosis - the previous one in August did show reduced density but I was not told about this. So I switched back to the Tamoxifen and the aromastase inhibitors cause you to lose my bone density. I figured I don’t have much oestrogen now if any and Tamoxifen does protect against the bones.
Its all pros and cons but if you are going to switch make sure you keen an eye on your bone density by having scans.