Breast Cancer Recurrence

[nannyct]

I am approaching 5 years clear of Breast cancer. I was diagnosed with Stage 1, Grade 1 ER+ right breast cancer in 2004. No node involvement at  all. However it was also Her2neu positive. I had a trt mastectomy w/ 16 lymph nodes excised, all negative. I then had 4 cycles of Adriamycin and Cytoxin. I have now nearly completed 5 years of Arimidex, My Oncologist ir recommending that in October I change to Femara secondary to a clinical trial which has concluded that  I am at some risk of the cancer still recurring. I am unsure about this as the side effects of the arimidex  hot flashes, weight gain etc causing me to be on a high dose of Effexor are quite debilitating at  times. What are my risks if I choose to just stop the Arimidex and not continue with a change to Femara...My oncologist thinks the risk is there because of the Her2neu but she herself says she is extremely conservative. Also I did not receive any herceptin, I was 18month to 2 years post diagnosis when that was cleared and my previous oncologist (in California) felt the risk outweighed the benefits for me. I would like some advice to help me make an informed choice.Thank You

[aniemay]

Just have to say that I had the exact profile, stage 1 HER2+ cancer, mastectomy, 18 clean nodes in 1998.  Sadly, I had a metastatic recurrance  in January 2008, 9+ years later.  I did not have any treatment outside of the surgery, which was the standard at the time. I would consider Herceptin if I were you as it has been shown to decrease recurrance by 50% even long after the original dx.  I have been on it since my tragic recurrance, and have not had any negative side effects from it.  The cardiac issues so often spoken of are very rare.
Good luck, and treat recurrance as a very serious risk- I wish I had.

[Cleveland Clinic]

Dear nannyct,  The current data with "extended adjuvant therapy" (beyond the initial 5 years) is with letrozole (Femara) after 5 years of tamoxifen. Letrozole and anastrozole (Arimidex) are both aromatase inhibitors and are very similar to one another. In most of the adjuvant studies using these drugs, 5 years of treatment has been given. An ongoing study will compare 5 to 10 years of aromatase inhibitors but there are no results available yet on that study.