Really scared please help

[Debbie L.]

You're worrying too much. (friendly smile, we ALL worry too much, and you asked us to tell you that, right?)

>>You said you often see premenopausal people on tamoxifen when her2+, but are they also on their year of herceptin when on tamoxifen (have you ever seen this?)

Yes, all the time. I think that's exactly standard of care. Premenopausal women who have adjuvant or neoadjuvant standard-of-care chemo/Herceptin go on to receive a year of Herceptin and if ER+, Tamoxifen. There are some who will have their ovaries removed or suppress ovarian function -- and some of those will also take Tamoxifen while others will use an AI. You could reference the NCCN guidelines on that (I will do that eventually but don't have time right now).

I'm glad you're getting another opinion because although it's possible the new opinion may "prefer" an AI, I'm almost certain they will reassure you that the Tamoxifen is also a fine choice.

Debbie Laxague

[Debbie L.]

NCCN endocrine tx guidelines, which are linked from the HER2+ tx ones:

Hmm, 'can't seem to link directly to, nor copy/paste from, the actual guidelines. If you go here: http://www.nccn.org/professionals/ph...nes.asp#breast

And click on the guidelines link (not the one for patients, but the first one), and then in the table of contents choose "BINV5" under adjuvant therapy, it should take you to the HER2+ page, which again has an option to link to the "adjuvant endocrine therapy" BINV-J page. Where again no distinction is made among the available endocrine therapies, as regards HER2+ disease.

I think you have to attest to being a medical professional, to enter this part of the guidelines. But I don't think there are any website police currently working to control this "problem" of fraudulent access.

Debbie L.