What questions should women ask their doctors about hormone therapy for breast cancer?
The first and most important question is how a woman’s menopausal status has been established. To be confident that a woman with ovaries is menopausal and a candidate for an AI, the doctor should document that menses (periods) stopped naturally at least one year before starting either chemotherapy or hormone therapy for breast cancer. If chemotherapy caused a woman’s menses to stop, then she should be considered pre- or perimenopausal (the time when menstrual periods become irregular as a woman approaches menopause), and initial hormone therapy should include tamoxifen and not an AI. If an AI is suggested as initial therapy, it may be helpful to ask what the plan will be if a woman has intolerable side effects. Finally, it’s fair to ask which clinical trial your doctor is using to inform your treatment plan. Dr. Hudis is a medical oncologist and chief of the Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center in New York City. He is also the co-chair of the Breast
