Letrozole prior to surgery

Hi I was diagnosed stage 3 last Oct and was told to come straight off hrt but didn't start the letrozole until after surgery. So stopped hrt end Oct had surgery 14th dec and started letrozole March. 

The side effects can be severe to start with so I think it's a bit harsh but double check there is no other way of doing this x

Good luck 

Thanks Trish, yes am going to call the nurse on  monday I think to discuss. How are you getting on with the Letrozole? X 

To start with I found the joint pain difficult and I'm now on ibandronic acid too. The worst part for me was when I started that as well so hard to say which side effects from which. 

The hot flushes are back to what they were before the hrt the memory loss is a bit rubbish but all what you would probably call menapasual systems. 

Wish you all the best have they said what else if anything you will need or is it too early 

Sorry you find yourself here, where none of us wanted to be.

The starting of treatment by 'stopping' the HRT is because I believe HRT contains various hormones - the main one would be 'oestrogen'.
You say you are ER+ .... this is the type that for want of better words 'feeds' on 'oestrogen' (hence wanting you to stop the HRT straight away).

The Letrozole prescribed is to 'deplete/take the oestrogen' out of the body .... thus reducing the amount oestrogen available for 'it' to feed on. 

With your operation in six weeks the prescribing the letrozole 'before' your operation will be to help reduce the available oestrogen and in doing this will/should/may reduce the size of your tumour.   

I was prescribe letrozole 'before' my operation - I even wrote on here about being so scared to take it thinking I would wake up the following day like some kind of monster..... however now I have the t-shirt I can say nothing changed overnight, it takes time to get into your system and time to get the oestrogen out of your body - yes there are side effects but I think only a percentage are side effects from the tablet itself the others are the side effects from my body having the oestrogen reduced - I class the oestrogen as the bodies very own WD40 lubrication hence the aching and stiffening feeling in various joints - again, not everyone goes through the same - some none, some a little others more - its a type of trial whilst always remembering that the letrozole is given to reduce the oestrogen that 'it' feeds on and after the operation with a few of it helping to avoid any reoccurrence. 

You may have a stainless steel 'marker' inserted at the area - this is done to know the actual location and depending on size and your bodies response to the letrozole you should see a reduction in size (hence depending on size if small and 'it' shrinks sometime it is harder to local - hence the marker.

I believe they will of suggested this type of treatment for you for what they see as beneficial for you.  
I do hope you are able try to try what they suggested especially at the start of treatment - this way 'at least you have tried'.  
Talk as ask if medications can be changed 'after you have had 'it' removed.

Hoping this helps.

Wishing you all the best.

Hello AlysG,  Had DCIS and told to stop HRT as ER positive.  But I had just had pellets put in in August and it was September 2021 so knew I would feel good for awhile.  Was then diagnosed with Stage 1 IDC in other Breast in November so things got crazy for me. I had been on HRT for 16 years too but was diagnosed at 71 years old.  Long story short.  WS started in Anastrazole after radiation.  
These hormone blockers are a bit rough especially after feeling good on HRT but I am on year 2 and still hanging in there.  Take care and good luck to you.  
Barbara

Hi Trish, I had just been prescribed alsndronic acid for osteopaenia, otherwise I would have been given that too. All they have said is Letrozole immediately, stop HRT immediately, then surgery radiotherapy and maybe or maybe not chemo but unlikely. I think I will need to look at something to help the hot flushes. Sorry you are suffering. Xxx 

Thanks Barb! Xxx

Thank you for your reply. You are right, I do need to at least try it!! I tried to cut back on my HRT before and even going to half measures caused immediate night sweats and hot flushes. I am going to ask the nurse what my ‘score’ was for ER+, as maybe it’s 8/8 which is why the consultant wants to go for such a severe approach! I don’t think it’s to do with shrinking the tumour as mine is 18mm ( I asked the radiologist at the time) so not that big in the greater scheme of things. I don’t have markers or anything- the lump is clearly visible and very easy to feel. Also I presume they didn’t want to monitor the shrinkage.  Also no sign of it having spread to my lymph glands on the ultrasound  but of course they will do the sentinel moose biopsy to check. Even the nurse suggested ( after the consultant had left) not to start the Letrozole straight away but to cut back on the HRT for a week or so first. 

I had an early menopause so been on HRT since I was 42. Severe menopausal symptoms at time.  Now 58. As you can tell, I am very attached to it but I know it has to go!! XXX

Hi AlysG

I was also told to stop HRT and begin Letrozole then had surgery weeks later.  Haven’t felt too bad except for feeling a little more tired than usual and achy. Of course the hot flushes have come back which isn’t ideal but I know it’s necessary! I’m early fifties.

Hi there, I had the same experience - stopped HRT immediately and started letrozole 6 weeks before surgery. I’ve been on it for about 15 months and tolerating it quite well.  I think this research may be driving these treatment decisions 

www.icr.ac.uk/.../longer-course-of-hormonal-therapy-before-surgery-for-breast-cancer-has-greater-impact-on-tumour-growth

My oncologist prescribed oxybutynin hydrochloride to help with hot flushes and it has helped a lot ( I had to ask for it though!)  

wishing you all the best for your treatment xx