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Breast Cancer/DCIS and Aromatase Inhibitors

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Expert: - 5/28/2010


Question
Hi, I was wondering if you could point me towards current evidence (i.e. studies) regarding aromatase inhibitor or SERM therapy as prophylaxis following ER+ DCIS treated with lumpectomy and tamoxifen, without radiation, specifically using hormonal therapy for more than five years. It is my understanding that recommendations for therapy was 5 years, but may be increasing now.

Thanks

Answer
Well, I would not myself treat a patient in that way. In my experience and according to all my training a lumpectomy SHOULD be followed by radiation therapy. I have yet not seen any convincing evidence against that attitude. If Tamoifen or an aromatase inhibitor also is used may be a matter of taste though probably the aromatase inhibitor is somewhat better. If the tumor was positive for hormonal receptors as in this case I would definitely also recommend aromatase inhibitor (or maybe Tamoxifene) treatment. But I would not abstain from radiation therapy or recommending it just because of that.



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Claes-Gustaf Nordquist, M.D.

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I`m a doctor of medicine and a specialist in radiation therapy and medical oncology. I have long experience in diagnostics and treatment of breast tumours.

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I'm a Doctor of Medicine and specialist in Medical Oncology and Radiation Therapy educated & trained in Sweden. Now retired. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps.You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 I have no restrictions on the number of questions there.

I also answer questions about Oncology (General Cancer), General History, Military History, Brain Tumors, Colon Cancer

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I'm a medical doctor and specialist in medical oncology and radiation therapy.

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