Patient's question:
Patient: Female, 53 years old. On July 24, 2013, she underwent left breast cancer surgery with nipple-areola preservation, total mastectomy, sentinel lymph node biopsy, and immediate breast reconstruction with implant. Postoperative pathology showed ER++, PR++, C-erbB-2 (1+), Ki67 (<5%), with no lymph node metastasis. She had not yet gone through menopause at the time of surgery.Doctor's answer:
1. For endocrine therapy of hormone receptor-positive breast cancer in postmenopausal women, the efficacy of aromatase inhibitors is indeed better than tamoxifen, but the absolute difference in efficacy is far smaller than the difference in price. However, the prerequisite for switching to aromatase inhibitors is to ensure that the patient is already in a postmenopausal state; otherwise, the effect will be much inferior to tamoxifen.2. The most recent hormone test indicates that although E2 levels are consistent with a postmenopausal state, FSH levels are not particularly high (comparing FSH values to the reference range for menopause of 48-144). It is recommended to continue follow-up of hormone levels at the local hospital. If consecutive two hormone receptor tests both indicate that E2 and FSH are in a postmenopausal state, then it is safe to switch to another endocrine therapy medication.