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>I figured she needs an AI --- or a new onc !
>What do you think ?
I think Tamoxifen's fine. The additional benefit of an AI over Tamoxifen is quite small, especially for those already at low risk of recurrence (ERPR+, HER2-, stage I). AI's are much more expensive. Tamoxifen has a long track record and we know its risks. AI's have a relatively short track record and questions remain about their longterm risks (cognitive, cardiovascular health, bones, etc).
It's not a recommendation (yet) as far as I know, but she might want to ask about being tested for CYP2D6 enzyme function as that probably has a role in metabolizing Tamoxifen effectively. Alternatively, she could take the Tamoxifen and see if she has side effects (mainly hot flashes) which may be a sign that it's metabolizing well in her body. So far, just a few studies are talking about these things (CYP2D6 and/or symptoms) so these are pretty loose recommendations.
Debbie Laxague
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