Is Arimidex a good choice for me after my bi-lateral mastectomy?

[kathy146]

I have stage one invasive lobular carcinoma in one breat, well-differeentiated tubular aadeeno carcinoma in the other. I've chose bi-lateral mastectomy, no reconstruction. If nodes are positive I'll face radiation, chemotherapy, etc. But I do not want to take Tamoxifen. I've read so many horrible experiences about it, etc. I am 55, almost menopausal, (tiny amounts for few days, maybe twice a year for 2 years now, it's ridiculous & I want to be fully in menopause. What's your opinion on Arimidex for me? Or is there something better?  Thank you!!!!

[Dennis MD]

Hi.
Tamoxifen and Arimidex are hormonal treatments for breast cancer.  Tamoxifen is given in premenopausal and postmenopausal patients with hormone receptor positive breast cancer.  Serious side effects include thrombosis (formation of blood clots), endometrial cancer (cancer of the uterus), and stroke.
Arimidex is an aromatase inhibitor.  This is given in postmenopausal patients with hormone receptor positive breast cancer.  Serious side effects include joint pains and fractures.
Your treatment will depend on a lot of things.  Prognostic factors need to be considered in deciding which treatment to take.  These factors include the stage of the cancer, hormone receptor status, Her2Neu status, proliferation indices, etc.  These can be determined after your bilateral mastectomy.

[kathy146]

Thank you for clarifying this. I'd much rather chance joint pain than uterine cancer and thombosis!  I have a huge fear of getting a  blood clot (I have some varicose veins in my legs and had one bad one removed once). ...It really seems that more people have  so many terrible reactions to Tamoxifin,more so than other drugs!  I'm trying to do a lot of research of the drugs I can choose from. Yes, my cancer is estrogen positive, progesterone positive, HER negative, early stage, the rest unknown I guess til my surgery April 28th...

[Dennis MD]

Hi.
Thanks for the update.
Since your cancer is hormone receptor (estrogen receptor and progesterone receptor) positive, you will respond to treatment with hormonal therapy.  But this is only a part of the whole picture.  Other factors will need to be considered before deciding on further therapy.  This will come after your surgery once the pathology result is already out.
For early breast cancer, surgery is usually the initial mode of treatment.  Adjuvant therapy in the form of systemic therapy (hormonal or chemotherapy) and/or radiotherapy will follow.
Please do post your updates.
Good luck on your surgery.  I’m praying for its success.  

[kathy146]

Thank you so much!  My anxiety is terrible today, surgery in a few days, and (our) worry now is about the fact that the surgeon says this is  an outpatient procedure, I'll be going home a few or couple hours after surgery (from the hospital)  UNLESS I am recovering poorly or having problems, etc., and my husband thinks this is impossible, and has spoken to     two people at his office who say that this is not okay, etc.  I'm thinking that it might really just depend on how many l;ymph nodes are removed (if any, other than the sentinel). My doctor said it's standard proceedure, but I know that many surgeons do have their patients stay 2 nights. ANy insight, opinion? Thanks you so much., Kathy

[carme]

While there are people trying very hard to make it law that mastectomy patients get "required" hospital stays...I don't think you need it if you are not experiencing any problems etc. after your surgery.
Any time you have to stay overnight in a hospital you should have someone with you!  In fact you almost need to have them there 24 hours a day.  So being at home with someone at your beck and call will be better. Believe me, I know.
I had my surgery, bilateral mastectomies, at a large cancer center here in downtown Los Angeles.  When I awoke they offered to get me out of bed, the next morning,(which from past experience I knew I needed to do to start recovering from surgery effects). I was alone and sat in a chair for awhile, then lo and behold I started my period.  It was a couple of days late, so it was a gusher...sorry for the gory details, but it gets worse.  I kept pushing the button for help, but no one came. I had my IV's hooked up on a pole luckily.  I was able to get to the phone to try and call my girls, but our home number was out of the area and I was too doped up to figure out how to get a line out.  So, I made my way to the closet, got a tampex out and made my way into the bathroom.
It was no party, and I can give you the rest of the reasons why I insisted my doctor release me that DAY!  Never mind that I ended up loosing both my expanders 3 weeks and 7 weeks later do to infections I went home with FROM the HOSPITAL!!!!
I am flat and happy 4 1/2 years later...married to the same "breast man" for 22 years,  who would rather have me alive than be able to admire/play etc. with two 38 DDs.

PM me and I'd be happy to give you more details.

[Dennis MD]

Hi.
I understand what you are going through.
I think the decision to stay in the hospital or not after a surgery should come from the patient.  There are pros and cons involved.  What was mentioned by the previous poster is valid and is one of the consequences of staying in the hospital.  Aside from that, the cost of surgery will be minimized with shorter hospital stay.  However, since surgery especially mastectomy also involves a psychological aspect, with a drastic change in the body, it would be best to stay in the hospital for a couple of days.  You can be referred to a psychologist to tackle all the issues bothering you.  Complications of surgery can be observed and picked-up early for prompt intervention.
If you are uncomfortable in having an out-patient mastectomy, you should push to have yourself admitted even for a couple of days until you are already well enough to go home.
Good luck on your surgery.  My prayers are with you.