This is Dr. David
AIs are only used for patients who are 1-2 years after their menopause.
so you have to use tamoxifen for now
and then 1-2 years after the ovaries are ablated,
and your estrogen levels drop down, then you switch to an AI
I think this was a report on the SOFT/TEXT trials which suggested that AI's would be better for premenopausal women?
AIs are never used for premenopausal women.
AIs block the conversion of steroids into estrogen.
tamoxifen blocks estrogen from going into estrogen receptors.
so tamoxifen can be used for both pre and post menopausal women
AIs are only used for postmenopausal women.
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I thought the trial compared ovarian ablation plus exemestane and ovarian ablation plus tamoxifen and concluded that o.a + exemestane was more beneficial?
the ovarian ablation has to be done first and then exemestane (aromasin) can be given since the patients are then postmenopausal
since the ovaries are then ablated.
so you can have ovarian ablation and then an AI.
the ovarian ablation causes you to be postmenopausal.
So do you think ovarian ablation is a good idea? When would I change to an AI? Also, I read on adjuvant online that it is thought that tamoxifen can act as a weak oestrogen in low oestrogen states, so that is a concern.
that is not a worry about tamoxifen.
if you are perimenopausal, best to still use tamoxifen for now.
get your ovarian ablation
and then switch to an AI 6-12 months after the ablation.
Thank you for explaining. I think it's monthly injections to begin with.
the ovarian ablation? yes.
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