What's it like choosing between endocrine therapy options after mastectomy?

These treatment decisions after mastectomy can feel overwhelming, especially when weighing the different impacts each option might have on daily life and future health. The factors that often help people navigate this choice include their age, family planning goals, existing side effect tolerance, and detailed discussions with their oncology team about their specific cancer characteristics and risk factors. Hopefully others in this community who've faced similar decisions will share their real-world experiences with both approaches to help give you a clearer picture of what each path might involve.

Hi Jennifer. May I ask how old you are? I was 52 when I was diagnosed and I was not in menopause yet. Ultimately, I went onto an Aromatase Inhibitor (which is usually given to menopausal women) rather than Tamoxifen. In part, it was because I was approaching menopause anyway but also because the other medications that were part of my treatment seemed to partner well with the Aromatase Inhibitor. On that treatment plan, I was in a No Evidence of Disease (NED) status for 9 months and then had a recurrence.

Hi jennifer- sounds like I was in a similar boat. When diagnosed I was 47 and pre-menopausal. I did tamox for a few months after bilat mast and reconstruction just to “catch my breath” and “steady the ship” Ultimately I chose zoladex monthly injection, aromatase inhib, and major lifestyle changes - I did that based solely on the fact that there was a slight advantage in outcomes for my cancer type, etc There are so many factors to consider but i always tried to focus on absolute best chance of living a longer and healthy life..whenever a decision had to be made, I tried to prioritize that. If treatment had been intolerable, I would need to pivot but I’m grateful it’s been manageable. I guess I just found it helpful to have one main goal and go for it 100% unless something made me have to change course. For me it was based on my age, kids, kids ages, etc and helped focus me and helped steer decision making. Not an easy place to be when you have to make big decisions but wishing you peace with what you decide and knowledge that perhaps you can change course if you find it intolerable…