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Old 03-23-2015, 12:51 PM   #1
Donna H
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effectiveness?

Does anyone know how effective Femara is (or the other "5 year" drugs such as Arimidex or Aromasin)? My onc put me on it but didn't really explain how much it will help.
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Old 03-23-2015, 06:28 PM   #2
Lisalou
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Re: effectiveness?

In head to head studies the AIs (of which femara is one, as well as the other mentioned are all same class of drug) performed better than 5 years of Tamoxifen in preventing recurrence, but one must be post-menopausal to receive it.
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[SIGPIC]Lisa
Routine mammogram 12/20/2013
Call back with repeat films on12/31/2013 Ultrasound with core needle biopsy same day
Dx 1/2/2014 IDC ER/PR+
1/10/14 HER2 +
2/14/14 BRCA results negative
2/17/2014 skin & nipple sparing BMX with reconstruction Tissue expanders placed
IDC Stage 2A left breast. 9mm tumor no other CA 1/4 nodes positive
ER + PR + Her2 +(by FISH)
Right breast no cancer, sclerosing adenosis
3/13/14 Round 1 AC minimal side effects
3/27/14 Round 2 AC
4/10/14 Round 3 a little more nausea
4/24/14 round 4 hurray! Done with phase 1!
5/8/14 THP ( taxol weekly x12, Herceptin & perjeta every 3 weeks x 4)
7/24/14 done with chemo
Continue of Herceptin every 3 wks x 1 yr
5/14 start Tamoxifen x 5 years
8/18/14 removal of TEs silicone implants placed
9/14/14 Cellulitis Right Breast, suspect infected implant. Managed with Oral antibiotics, avoided surgery to remove implant. Whew!
12/17/14 nip & tuck revision of Left breast

We gain strength, courage, and confidence by each experience in which we really stop to look fear in the face. The danger lies in refusing to face the fear, not in daring to come to grips with it. We must do that which we think we cannot do. -Eleanor Roosevelt
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Old 03-23-2015, 09:56 PM   #3
JessicaV
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Re: effectiveness?

My cancer is not oestrogen receptor positive, so I don't take these, but I just heard of apremenopausal woman being given another drug to put her through menopause so she could then take AIs because she could not tolerate Tamoxifen. (If she got the story straight and I remembered it straight)
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1997-2004 many cysts, many MG & U/S: polycystic breasts.
Sept 2013 found lump,Cyst?? forgot lump.
Dec 2013 GP check, Referred for U/S, MG,FNA.
7 Jan 2014 Radiology: Radiologist turned screen away from me. When asked she said "Not a cyst, very suspicious.See your GP asa results avail."
Cancelled my psych clients for the week.
8 Jan 14 GP: 2.2cm IDC in 6cm DCIS field. FNA=malignant cells. Referred to Surgeon.
Cancelled my psych clients for the month.
13 Jan
14 Surgeon said L mastectomy not lumpectomy, offered neoadjunctive trial, agreed adjunctive chemo after surgery a good choice for me. Booked Body scan and bone scan for staging (both fine) Surgery for16 Jan,
16 Jan 14 Surgeon also agreed in preop meeting to also remove 6cm fatty cyst in job lot. Good job done.
19 Jan 14 discharged home with 1 drain.
22 Jan 14 drain partly pulled out overnight, serious seroma (600 ml reducing removed every 2 days for a month) Serious staph infection because nurse said wait 3 days for yr surgeon appointment.
26Jan 14 pathology: 2.2cm Grade 3(3,3,2)ER-, PgR-, HER2+2 so to be confirmed by Sish test. Node negative. No vascular or lymphatic involvement. No metastases in scans.
30 Jan 14 HER2+ high amplification, 13 gene copies per cell.
21st Feb 14 Began 3wkly TCH adjuvant treatment at The Mount Hospital Perth, with 3monthly MUGA heart tests +Oncologist or Surgeon full physical check-up.
Cancelled my psych clients for 6 months.
Feb 14 First MUGA test: 71%,
First C15.3 test: 20
7th March 14 began Neulasta self-applied injections 24hrs after each TCH treatment. Bonepain helped by spa, heatpacks and
Claritin, reflux/indigestion helped by Somac.
July 14 completed docetaxol and carboplatin, ongoing herceptin to 12 months. Severe cognitive deficit/fatigue after 1pm daily.
Sept 14 Second MUGA test: 69%
Cancelled my psych clients for 2014
Dec 14 Third MUGA test: 70%
Second C15.3 test : 20
Cognitive fatigue delays return to work.

March 2015 Tachycardia pulse 168, night in hospital. Cardiologist says no heart disease, ALIVE ECG attachment for my mobile phone now regular monitoring.
July 2015 Worktrial, up to 8hrs per wk. Fatigue ongoing
Aug 2015 Heart good, no evidence of cancer, just Fatigue.

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Old 03-24-2015, 08:10 AM   #4
Donna H
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Re: effectiveness?

Hi Lisalou- Thanks for your response. Do you have any idea what "performed better" translates to in actual numbers? A 5% increase or maybe a 25% increase? Apparently I am one of those people that needs to know specifics so I can judge if there is a diminishing return on my investment so to speak. Is taking Femara worth the side effects. My onc team typically tells me I am receiving the "Gold Standard" of treatment but that really doesn't tell me much. Seems like if jumping off a bridge was the gold standard I'd be doing that too! I probably think too much - what if? what about?
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Old 03-24-2015, 12:15 PM   #5
Becky
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Re: effectiveness?

Donna

How er and pr positive are you?
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Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 13 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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Old 03-24-2015, 01:36 PM   #6
Donna H
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Re: effectiveness?

Hi Becky -
I have no idea and I feel pretty silly not knowing. Does that effect or change how effective Femara is or how necessary it is?
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Old 03-24-2015, 08:27 PM   #7
Becky
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Re: effectiveness?

Yes, it does. Your pathology report should have something on there about it
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Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 13 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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Old 03-25-2015, 09:02 AM   #8
Donna H
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Re: effectiveness?

Hi Becky-
I have my path report although I think it is written in a foreign language. Is this what you were asking - estrogen receptor positive, progestorone positve, HER2+. It is invasive ductal carcinoma, nottingham grade 3, glandular score 3, nuclear pleomorphism score 3 and mitotic rate score 2. No node involvement. I probably should have really read the report many months ago - unfortunately we sold our house and moved (8 hours away, different state), then my Dad died and my Mom moved in with us right after my surgeries. Then I started chemo etc. It's been a wild ride!
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Old 03-25-2015, 10:38 AM   #9
Becky
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Re: effectiveness?

Yes. Alot of times it says how positive you are. For example, i am 50% estrogen poaitive but I am progesterone negative. Anyway, all "antihormonals" work best of you are positive for both which you are. I dont know the stats on survival improvement but it is significant as hormone positive cancer tends to recur later in the game. There is always an early peak but unlike hormone negative bc, there is a 5-8 year second peak. This peak is oddly about when the 5 years of tamoxifen/femara type drugs is over. Hence studies to take it 10 years. The 10 year tamoxifen study shows the 10 years is only marginally better at ten years but 10 years has a significant carryover effect. Giving added protection for many years thereafter. I highly recommend therapy. I have been on Arimidex for 9.5 years. I am figuring in september my doc will take me off. If you have side effects when on femara, you can switch to arimidex or aromoson or even tamoxifen. There is risk reduction but i cant tell you what it is
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Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 13 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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Old 03-25-2015, 12:27 PM   #10
Donna H
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Re: effectiveness?

I was 100% estrogen receptor positive, 1% progesterone positive and Her2 2+. On another page it lists the Pathologic Staging as pT2, N0 (sn), i- M-N/A
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Old 03-25-2015, 02:17 PM   #11
Debbie L.
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Re: effectiveness?

In large groups of ERPR positive women, the benefit of endocrine therapy (AIs, Tamoxifen) is probably in the area of 30-50% relative reduction in recurrence. But as others have said, it's believed that the benefit may be higher for cancers that are highly ER+ and lower for those that are less ER+. Plus there's new information (and more to come) about the benefits of endocrine therapy continued beyond 5 years.

But that is only the relative risk reduction, and that has to be factored into your individual risk of recurrence (factoring in stage and other details of the cancer), to get the absolute benefit to you.

For example, if a woman completed treatment with a 50% chance of recurrence, and then did endocrine treatment that reduced her risk by 50%, she would be left with a 25% absolute risk of recurrence. Another woman with a 5% risk of recurrence after treatment would have that reduced to 2.5% with the same treatment. IOW, the higher your risk of recurrence is, the more absolute benefit you will gain from any treatment.

Your oncologist is the one to ask for these numbers. Again, they will have been garnered from large groups of women who may not be exactly matched to your individual cancer details, but they will be the closest we can get, and helpful in making treatment decisions.

Here's a quotation from a fairly-recent (12/2013) article regarding 5 years of Tamoxifen: "In the most recent Oxford overview of women with estrogen receptor (ER)-positive breast cancer, which included 15 years of follow-up, use of 5 years of adjuvant tamoxifen (compared with no therapy) resulted in a halving of recurrence rates during years 0 through 4, and a reduction by one-third in years 5 through 9." The article is actually discussing duration of therapy (and there is newer data also supporting longer therapy), but it has some useful information for your question:

Adjuvant Endocrine Therapy for Breast Cancer: How Long Is Long Enough?

But again, you should ask your oncologist to go over this with you. It could probably be done with a phone call.

Debbie Laxague
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Old 03-27-2015, 10:06 AM   #12
sarah
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Re: effectiveness?

Today they are suggesting AIs be taken for 10 years so after 5 years, ask your doctor about that. Also try taking the pill at night.
take care
sarah
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Old 03-27-2015, 12:04 PM   #13
Donna H
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Re: effectiveness?

When did most start taking Femara (or other AI) - while still getting Herceptin or after? After chemo finished or while chemo?
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Old 03-27-2015, 02:59 PM   #14
jaykay
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Re: effectiveness?

I started after radiation - after chemo and during Herceptin
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March, 2000: 48, Post menopausal (5 yrs HRT) Left breast, IDC 3mm/DCIS 1.6cm, ER+/PR-/Her2+++, mod differentiated, MIB low, lumpectomy, node neg via SNB, rads=33 Stage 1a
June, 2000: Tamox 4.5 years,Femara for 5 years (end in Jan. 2010)
Sept, 2012: 61, Via mamm, ultrasound, biopsy, right breast, 2.3cm tumor, ER+/PR-/Her2+++, poorly diff, KI67 60-70%
BRCA 1 and 2 negative
October, 2012: Bi Mast with tissue expanders, port placement
Final Path: IDC 2.8cm, DCIS, 1/4 sentinal nodes positive (@#$%). Stage IIB
Nov 29, 2012: Begin TCH/6x/every 3 wks, H for 1 year/every 3 weeks.
March 14, 2013: Finished chemo
April 9, 2013: Begin radiation 28x
May 22, 2013: Finished rads
June 1st, 2013: Started Aromasin for 5 yrs.
July 15, 2013: Switched to Letrozole (Femara). Probably for the rest of my life
October 16, 2013: Exchange surgery
October 31, 2013: Finished Herceptin
December 5, 2013: Port removed
Glad this year is over!
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Old 03-27-2015, 04:09 PM   #15
LizzElliot
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Re: effectiveness?

I just switched from Tamoxifen to Femara. I was put on Tamoxifen and had some side effects I didn't care for. Had blood tested for post-menopausal status (which we all figured I probably was) and I am. So I switched to Femara. So far, I don't notice side effects.

Just was talking to my Oncologist about this so here are the notes I have...

Femara (and assuming all AI's) has a slight advantage on risk of recurrence percentages for post-meno women. If (*if*) one had a 100% likelihood of recurrence, taking Tamoxifen (which is ok for post-meno women to use) cuts that risk by 51%. If one had a 100% likelihood of recurrence, taking Femara cuts that risk by 54%. (Assuming we might have less than a 100% likelihood of recurrence, then the risk goes even lower, of course).

Anyway, the difference between Tamoxifen & AI is 3% advantage to the AI. May not seem huge, but 3% is 3%!

For post-meno women who cannot tolerate the AI, then going back to Tamoxifen makes sense because then, rather than taking nothing and losing all that 50+% advantage, you are getting 51% advantage.

Cheers,
Lizz.
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Old 03-27-2015, 04:33 PM   #16
Carol Ann
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Re: effectiveness?

My doctor started me on Arimidex right after chemo and while still on Herceptin ... but I had had another ER/PR + tumor that wasn't also HER2+++ to worry about in the other breast (see my signature). He told me he didn't want to give the other tumor any window of opportunity. Both of my tumors were very strongly estrogen positive.

Carol Ann
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July 24, 2013: "Infected" Right Nipple and benign cyst removed, pathology report revealed Paget's, DCIS, and ILC 1.25 cm, ER+/Pro+/HER2 equivocal, Grade 2 under benign cyst, previous diagnostic mammo/ultrasound said I was perfectly healthy in both breasts.

Aug 18, 2013: MRI report says Left breast is perfectly healthy "consistent with previous studies".

Sept 2013: I insist on a bilateral mastectomy anyway. Too nervewracking to let left breast remain with higher risk after 3 cancers in right, nipple in right is already gone anyhow.

Sept 18, 2013: Bilateral mastectomy, 11 right nodes removed, ALL negative BUT -- ER+/PRO+/HER2+ tumor, 1.0 cm, Grade 2 found in a piece of "grossly unremarkable" breast tissue from prophylactic mastectomy of left breast, no nodes removed.

Oct 25, 2013: 13 left side nodes removed, ALL negative, Stage 1 across the board, NO RADS needed, YAAAAY! Port also installed.

Nov 25, 2013 Begin 6 rounds TCH.

March 10, 2014 Just finished 6th and LAST Chemo today, YAAAAAY!

March 24, 2014 Echocardiogram to make sure I'm still good for Herceptin every 3 weeks.

March 31, 2014 Echo results NORMAL, first Herceptin all by itself. Now if only my eyes would stop streaming from the Taxotere ... :)

April 21, 2014 Started Arimidex and therapy for "mild" lymphedema in left hand and arm

May 2014 Therapy completed, I have sleeves and gloves for both arms, a Flexi touch lymph pump to hook up to for an hour every day, and I've become an arm bandaging expert. :)

June 2014 Begin Fosamax to prevent osteoporosis; bone scan revealed osteopenia

Nov 17, 2014 FINAL Herceptin!

Dec 4, 2014 My right thigh muscle has been extra achy for days ... I discover a blister rash cluster on the side of my right thigh while taking a shower. Port appointment cancelled until Dec 17, my doc is working me in tomorrow afternoon to see me and the rash. My muscle at least feels less achy.

Dec 5, 2014 Yep, I have shingles. Boo! I start acyclovir and also have a prescription for a painkiller just in case for over the weekend.

Dec 17, 2014 Port is OUT!

January 2016 Shingles again and this time it started where my left breast (where the hidden HER2+++ tumor was!) used to be. My onc nurse got me a same day appointment to see my doc when I called and told her I had a rash on the site. The antiviral meds are working once again, though, so that is good news. :)

Last edited by Carol Ann; 03-27-2015 at 04:34 PM.. Reason: added info
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