HER2 Support Group Forums - View Single Post - Roll call for premenopausal Her+ and some hormonal positivity

Janelle · 06-29-2008, 08:48 AM

Suzie,
AI's are anti-hormonal therapy but they can only be used in post-menopausal women. If I were to have my ovaries removed or if I had gone into menopause naturally or from chemo, then an AI would probably be recommended to me. But I am pre-menopausal which is why I am on tamoxifen. My body is still producing alot of estrogen and tamoxifen helps the breast cells from absorbing it. An Ai (alone) is not a strong enough anti-hormonal therapy for a premenopausal woman.

As for Slamon's advice....He didn't actually tell me not to take tamoxifen. He didn't think it would hurt but he just wasn't so convinced it would help a lot (or at all). Basically, the gist was in his opinion if I had terrible side effects from tamoxifen then I would not be crazy (or killing myself) if I decided to stop taking it.

My primary onc did convince me to give it a try so I did....and much to my surprise I didn't have any terrible side effects so I stayed on it. She is still not recommending that I have more aggressive hormonal therapy (ovary removal, etc) even if I turn out to be PR negative. She still thinks I should stay on tamoxifen alone until more data comes out.

After listening to the George Sledge podcast, I get the idea that the medical community really doesn't know how much anti-hormonal therapy helps us HER2 positive ladies (especially those of us who are low-moderate Er/Pr positive or ER positive/PR negative). BUT since there aren't any answers yet doctors will continue to recommend the "standard of care" for anyone with any ER or PR positive breast cancers- which is some sort of hormonal therapy.

I hope this helps and did not confuse more....

Best,
Janelle

06-29-2008, 08:48 AM	#19
Janelle Senior Member Join Date: Nov 2007 Location: Brentwood, CA Posts: 76	Suzie, AI's are anti-hormonal therapy but they can only be used in post-menopausal women. If I were to have my ovaries removed or if I had gone into menopause naturally or from chemo, then an AI would probably be recommended to me. But I am pre-menopausal which is why I am on tamoxifen. My body is still producing alot of estrogen and tamoxifen helps the breast cells from absorbing it. An Ai (alone) is not a strong enough anti-hormonal therapy for a premenopausal woman. As for Slamon's advice....He didn't actually tell me not to take tamoxifen. He didn't think it would hurt but he just wasn't so convinced it would help a lot (or at all). Basically, the gist was in his opinion if I had terrible side effects from tamoxifen then I would not be crazy (or killing myself) if I decided to stop taking it. My primary onc did convince me to give it a try so I did....and much to my surprise I didn't have any terrible side effects so I stayed on it. She is still not recommending that I have more aggressive hormonal therapy (ovary removal, etc) even if I turn out to be PR negative. She still thinks I should stay on tamoxifen alone until more data comes out. After listening to the George Sledge podcast, I get the idea that the medical community really doesn't know how much anti-hormonal therapy helps us HER2 positive ladies (especially those of us who are low-moderate Er/Pr positive or ER positive/PR negative). BUT since there aren't any answers yet doctors will continue to recommend the "standard of care" for anyone with any ER or PR positive breast cancers- which is some sort of hormonal therapy. I hope this helps and did not confuse more.... Best, Janelle __________________ Janelle Diagnosed October 2006 at age 37 wtih grade 3 IDC and high grade DCIS Stage 1c triple positive, no node involvement but vascular invasion multifocal disease Lumpectomy November, 2006 A/C every 3 weeks (started Jan., 2007 and finished March 2007); followed weekly Taxol (finished June 2007) concurrent with Herceptin (finished March 2008); Bilateral Mast with immediate recon in Sept 2007; finished recon Dec. 2007 Started 5 years of tamoxifen Nov. 2007; started peptide vaccine clinical trial at MD Anderson October 2008 and finished active part of trial in April 2009 (monthly injections of AE37 peptitde (HLA type specific) with GM-CSF or GM-CSF alone depending on if I was in experimental or control group); started Zometa infusions June 25, 2009- 4mg every 6 months for 3 years (taking it "off-label" to try to prevent mets)