Alternatives to tamoxifen in premenopausal women

[pasupu]

Hi,I am 37 yrs.old.diagnised with breast cancer.completed 6 cycles of chemotherapy.Then had mastectomy.ER.PR+ve.Two yr.back I had a little episode of dizzi spell,my eye got half closed and had loss of balance,double vision for half an hour.Doc.s did ct scan of brain,did some tests for any abnormality in the heart.Everything was ok.They said it was TIA[TRANSIENT ISHCHEMIC ATTACK].It never reoccured again.Now ,my doc. feels that he should not prescribe TAMOXIFEN because of TIA.My question is,
1.was it TIA AT ALL?
2.If it was,can I still not use Tamoxifen?
3.What are alternative drugs to Tamoxifen?Are they equally effective?
I am aware of ovarian ablation.But I want to know about the drugs if any available as an alternative which do not cause blood clots.
Thank you very much.

[lizziecee]

I had a TIA, lost consciousness and had to be taken to hospital by ambulance. I was kept in overnight and saw a neurologist in the ER who checked my vision and hand movements. All okay. I was on tamoxifen, after finishing FEC chemo and during radiotherapy. I was switched to Arimidex and 2 and a half years later have not had another one.

[outofafrica]

A related discussion, tamoxafin and pulmonary embolisms was started.

[pasupu]

Thank you so much lizziecee, for the input.

[CCF-RN,MSN-rf]

Dear pasupu:  Without evaluation, we cannot speculate on whether or not you had a TIA.  Your neurologist would be best equipped to respond to this question.  The concern regarding tamoxifen is that it has a slightly higher than average risk of causing blood clots.  If you do have a history of a TIA related to a clot, there is concern that you may already be at higher risk of a thromboembolic event (such as a stroke, pulmonary embolus etc.).  In terms of your situation, it might be beneficial to explore a multidisciplinary approach.  Perhaps your oncologist could consult with your neurologist and they could evaluate risk versus benefit of the options and determine what options would be in your best interest, considering pros and cons.