[Debbie L.]

Nina, what about considering Tamoxifen, since you're on an anti-clotting drug anyway? Especially when you're still on Herceptin.

HER2+ cancer tends to be more resistant to endocrine therapy, and there was a time when it was thought that this was more predominant for Tamoxifen than for AIs. But I think it's been realized that that it's both (or neither).

Before you "take your chances" as your onc alluded to, I hope that you consider a trial of Tamoxifen, because endocrine therapy can be of great value to HER2+/ER+ cancers, and many women are able to tolerate Tamoxifen when AIs were intolerable. (see next paragraph about consulting with experts, since your circumstances are far from average).

So much that we do not (yet) know about individual variations in metabolism and efficacy of the various endocrine therapies, especially for HER2+ cells. But bottom line, I'd encourage you not to give up on endocrine therapy, and to get a 2nd (at least) and possibly a 3rd opinion about how best to proceed. From an NCI-designated comprehensive cancer center:
http://cancercenters.cancer.gov/canc...ters-list.html

Debbie Laxague