[Becky]

Dear Ann

I hit my 5 yrs on Arimidex in Sept (they aren't counting the 3 months I was on Tamoxifen so I guess I am getting alittle extra). My onc told me he was going to keep me on longer but that was awhile ago. The last time I saw him (after Thanksgiving), he commented that I only had about a year to go. I decided not to seize that moment to discuss being on longer as I will see him again in May and that will be a better time to address it and then reassess as I have a current prescription that will carry me through until now (which would be about 5 months over 5 yrs).

It's a real crap shoot of a decision to discuss. There is no real data on being on an AI longer than 5 yrs although if highly hormone positive (and not Her2+) it might make sense to fight to stay on (as long as the side effects are not super debilating). But the Her2 positivity does need to be considered too... downgrade the hormone receptors/upgrade the Her2 receptors? No one really knows. I do know that staying on longer is in trial now but there are no preliminary results yet. I was hopeful there might be but then, the AIs have only been approved for early stage bc since October 2004 so even if they kept some of the early trial women on longer, they may not have analyzed any results (or perhaps there have been so little statistical results, they want to see how it fares in reducing very, very late recurrences (lets say after 10 yrs out) and those very late recurrences are rare too.

Have a frank discussion with your onc on the pros and cons. Another thought could be to ask to go on Evista which works like Tamoxifen but without alot of Tamoxifen's bad side effects (and its good for the bones too). I don't know the answer but I am searching myself for the right route to go especially since I still have both of my breasts.

Peace to you