Tamoxafin/ Lupron

[wandering]

I am a 52 1/2 year old female, premenopausal (maybe peri?). I had a lumpectomy 1/03 for DCIS. It was small, no invasion out of the ducts at all. The margins were greater than 3 cms. It was estrogen/progerterone positive (which was actually checked out much later). I had 28 normal radiation days & 8 boost radiation days. I started Tamoxafin 5/03. I also had hormonal levels. The oncologist felt I was not close to menopause & said I might want to take Lupron to try and kick start it so the Tamoxafin would work "better". She had me see my GYN who talked with me & looked over the hormonal levels & said he felt Tamoxafin would put me in menopause. I have been on Tamoxafin 3 1/2 months, have had 4 cycles, one normal, one light & two normal (heavy) but shorter. I looked into lupron & did not like everything I read about potential side effects. I also read a news article on line about 3 months ago that said in 3rd world countries women were taking less Tamoxafin (unable to get full dosage) & doing just as well as women getting full dosage.......it was promoting doing a study to see if full dosage is needed. My estradiol level on the second day of my cycle (when hormonal levels were done) was 17 (lower than any potential levels listed). Other history, my mother has had bilateral mastectomies one from '86 & one'97...she is doing well. Should I potentially take the Lupron & try and kickstart menopause, or at my age with perhaps lower levels of estrogen should I just hang tight & see what the tamoxafin does? I'm concerned about so many side effects.

[CCF-RN,MSN-rf]

Dear wandering:  The research is not yet conclusive regarding the use of Lupron/zoladex in combination with the tamoxifen. It is believed to be a very aggressive approach. It has theoretical benefit but as yet I don't believe overall survival has been impacted. Lupron/zoladex WILL affect your quality of life, so it must be evaluated in this context.

[wandering]

Actually the oncologist concern is that I should be in menopause for the tamoxafin to work "better"..(less estrogen running around in menopause)...so she is talking about maybe jump starting menopause. I'm not sure reading the side effects of lupron it is even worth trying to jump start menopause. That would be her only rational for using it & then only until menopause starts.
Thank you for the information you provided.