Aromatase Inhibitor (AI) vs Tamoxifen for premenopausal women

Sounds like a great plan 

@Brenda5 @primek @melclarity @naomi.v @Deanne @iserbrown

Thank you ladies for responding to my original post. Apologies for the delay in responding. I had to take some time out as it was all getting a bit too much and was not in a good head space.

I guess the primary reason the oncologist recommended AI over Tamoxifen was that research has shown that AI + Zoladex for pre-menapausal women was more effective in stopping recurrence than Tamoxifen + Zoladex.

However, since my last post I have had a double mastectomy and now oncologist no.1 is saying that she's happy for me to be on Tamoxifen + Zoladex. As i will be getting ovaries removed after the age of 40+, I would then switch over to AI. So in total, 10 years of hormone treatment.

In short, f u cancer...

Agree with Deanne - definitely have a bone density test - mine is good for which I am grateful, it will give a good marker for the specialist to work with

Bone loss has been more rapid since I had my ovaries removed and switched to Femara. I am now doing weights twice a week at The Bone Clinic (Sunshine Coast, Brisbane and Gold Coast Centres) and am very hopeful that this will counteract the effects of Femara. There are medications for bone density but I was concerned about yet more side effects from these, especially in the long-term. But it is another option if the weights are not enough.

My oncologist was able to give me an idea of the different recurrence benefit between Tamoxifen and an AI for my particular situation. That was a big help in deciding what to take. We are all different and side effects are hard to predict until you are on the drugs. Definitely have a bone density scan if you have not already as this might be information that can guide you and your doctors. 

I am 36 - and at high risk for DVT (have already had 2 blood clots while on chemo) and so have been recommended Aromatase Inhibitors rather than Tamoxifen.
My oncologist advised me that one of the most important differences is that the bone density loss is much more rapid with Aromatase Inhibitors than Tamoxifen in premenopausal women - so it's something we would need to actively manage. Something to consider being so young!

Hi!  My treatment is Tamoxifen daily and Zoladex injection monthly for 2 years.  At the end of Zoladex treatment the Oncologist has suggested he will move me off Tamoxifen onto Arimidex.

We all react differently so it is hard to compare - my latest scan suggests my ovaries are healthy so we wait and see for the time to tick down, 10 Zoladex injections to go, but who's counting!

Do I suffer side effects?  Yes but it is hard to point the finger at which medication, these two or the other that I am on. 

Take care

As Aromatase Inhibitors give a bit better protection against recurrence than Tamoxifen, especially if you are at higher risk of recurrence, then that might be a reason to go with that plus the Zoladex. 
I was 47 at diagnosis and premenopausal. They thought that chemo had put me into menopause but I was placed on Tamoxifen and monitored. At the 18 month mark, my ovaries started working again and I then had them removed (being 49 by then) and started Femara (Letrozole).
I have had worse physical effects on Femara than I did on Tamoxifen (joint pain and bone loss) but I feel less moody, a lot more placid and easier to live with!
Talk it over with your doctors if you need to. The important thing is to understand your choices and be as happy as you can be with them. Good luck whatever you decide to do. xxx

Im with Kath, Im not sure why the recommendation for aramatose inhibitors. At first glance personally I would choose the Tamoxifen as that is for pre menopausal women. I was on this for 4yrs and honestly I didnt notice any side effects at all. Chemo however threw me into menopause immediately, so was dealing with horrendous hot flushes throughout chemo uuugh. I must admit, 9 months on, I still get hot flushes but not the quantity I was, so agree with Brenda, I do believe it lessens with time. Oh forgot to mention, my 2nd diagnosis was IDC Stage 2 Grade 3 and am ER+ only and clear lymph nodes. Biggest Hugs Melinda xo

From all I read aramatose inhibitors are only used in post menopause women or those who have had their ovaries removed as it doesn't work on the ovaries like tamoxifen does. I guess you need to ask the oncologist why they are recommending the various treatments to get a clearer understanding.  Best of luck. Kath x

From the day of my diagnosis and my Dr saying get off the pill, its feeding the cancer, my periods stopped dead in their tracks after being bang on regular every month. I don't know if it was the fright or the treatment but they haven't returned. I am on Tamoxifen and I did have a bit of bone aches and hot flushes every darned hour but after six months they have slackened off to very few bone troubles and only flushes every few hours except bang on dinner time every night when I need to cook. Family has gotten used to dinner half an hour later now lol.