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Are there any minuses perceived about having an ooph? I always thought it sounded like a pretty good idea, but two doctors have discouraged it in Ruth's case.
Hmm. From a purely breast cancer perspective I don't think that there are minuses other than the risk associated with any minor surgery. But for young women, we don't know much about the long term effects of such drastic estrogen suppression as is achieved with oophorectomy and AI's. Again, more questions than answers right now. There was a study reported a year or so ago about increased dementia when young women had ooporectomy (I don't think that it was a breast cancer-related study). I talked to some young women then whose reaction to that study was relief that they were using ovarian suppression rather than ooph. But who's to say they wouldn't have seen the same results either way? And again, we can't hang our hats on one study.
What are the longest term Tamoxifen vs AI studies available? I wonder if the stats will change in those crucial post ER treatment years. (crucial for those with ER+ bc)
Good question. I don't know. I think ATAC and MA17 are the main ones (adjuvant AI vs. T) - it's frustrating to search and keep getting links that require membership or payment. There are so many studies - T vs. AI right off, T for a few years and then AI vs. AI only. AI after T at 5 years. And in the podcasts I've been listening to, some have suggested that they are intrigued with the idea of alternating back and forth, or even having holidays of nothing between alternating. It would be nice if someone could tie it all up neatly for us in a summary of what we know. I don't think any of the questions are (yet) answered for sure. Which one? Which sequence, if sequenced? And especially - for how long?
I guess the good news here is that if one particular way was clearly much much better, we'd know that by now. So the fact that we're niggling with all these different scenarios probably does mean that the differences between regimens are fairly small and thus the decisions made are not that critical? That's easy to say in the global perspective but much harder to achieve nonchalance about for any one individual.
Debbie
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