Since I have done more that 1,700 posts on MH, I don't recall exactly which thread you are referring to.
However, if asked again today about the importance of accepting treatment with Tamoxifen or an AI, I would point out the established value of such treatments, despite the fact that each one (like most medications), carries certain side effect and risks. I would also inform the questioner that such treatments are recommended by experts in the field, The American Society of Clinical Oncology.
A recently released study reiterated the considerable benefit of such treatment:
"Five years of tamoxifen treatment -- with or without chemotherapy -- cuts a woman's 15-year risk of breast cancer death by about a third.
The reassuring finding comes from analysis of long-term data on 21,457 women with breast cancer enrolled in clinical trials of tamoxifen.
'Substantially reduced mortality rates for breast cancer continue well beyond year 10, as a delayed effect of the greatly reduced [breast cancer] recurrence rates during years 0 to 9 [after about five years of tamoxifen therapy],' report Christina Davies, MD, and colleagues in the international Early Breast Cancer Trialists' Collaborative Group (EBCTCG)."
Moreover, the guidelines of the American Society of Clinical Oncology (ASCO) include the following recommendations:
"To lengthen disease-free survival and lower risk for recurrence (i.e., locoregional or distant recurrence or contralateral breast cancer), postmenopausal women with hormone receptor–positive breast cancer should consider an AI, either as primary adjuvant therapy for 5 years or sequentially after 2 to 3 years of tamoxifen to yield a total of 5 years of adjuvant endocrine therapy. Women who discontinue initial AI therapy before 5 years should consider using tamoxifen to bring the total duration of adjuvant therapy to 5 years.
Women who have completed 5 years of adjuvant tamoxifen therapy can benefit from switching to an AI. This extended therapy should not exceed 5 additional years.
ASCO does not recommend using specific markers to choose optimal adjuvant therapy.
Because of drug interactions, caution is recommended when tamoxifen and CYP2D6 inhibitors (e.g., paroxetine, fluoxetine, bupropion) are used concomitantly.
When advising women about adjuvant therapy, clinicians should consider the adverse effect profiles of tamoxifen (venous thromboembolism and endometrial cancer, polyps, and hyperplasia) and AIs (osteoporosis, fractures, and arthralgias). Switching from tamoxifen to an AI (or vice versa) might be appropriate if adverse effects become intolerable or precipitate nonadherence."
The final decision, of course, rests with the patient and her doctors.
If you would prefer to receive your information from medical professionals, you might consider posting in the Breast Cancer Expert Forum, which you can reach by clicking on the link below:
http://www.medhelp.org/forums/Breast-Cancer/show/121
Thank you for your interest in the Breast Cancer Community Forum,
bluebutterfly