[dlaxague]

Hi Kristen,

Sorry, I assumed you'd had Herceptin because so many here have. Not that it changes this discussion (but it takes out some of the rambling I did, smile).

... so I can't see why a oophorectomy would not benifit me so I could go on femara

Well, yes, you would get "some" benefit. But almost everything also has risks/downsides in addition to benefits. So you want to weigh the risk and benefits both. Oophorectomy, for example, is a surgery and that carries a small risk in itself. Taking an AI certainly has risks. Some are relatively minor and probably relieved by stopping the AI. Others are less certain at this point, especially for someone as young as you are who could live with the side effects (if they are irreversible) for many many years.

So a useful way to make a decision as to whether the risks are worth the benefit, for any one individual, is to look at some numbers that give some idea of those risks and benefits. We'll each have different risks and benefits, and we'd each make different choices, even with the exact same information in front of us. But I think it's always a good idea to have that information in as much detail as possible. "Better" and "worse" just don't do it for me. I'm much less anal than before diagnosis but obviously, am still a recovering control freak.

I'm not trying to talk you out of this. I just want you to have as much information as possible.

Rambling OT now: It will be interesting to see the stats as the adjuvant Herceptin trials continue reporting longer-term data. I think that they were a little surprised at how many early recurrences happened, in the control arms. Soon we'll begin seeing what happens later on, with HER2+/ER+ cancers. Do they behave like the ER- ones, with more recurrences but most early and few late? Or do they behave more like ER+/HER-, with a continuing risk many years out?

In these podcasts that I've been listening to, Neil Love asks lots of questions of the experts he interviews, and a common one is "how are you treating women with a recurrence who had adjuvant Herceptin?". The answer is often that the MD has had very few or no women in this category - that their patients who got Herceptin just don't seem to be recurring. Cool!

Debbie