Adjuvant
chemotherapy plus tamoxifen in ER+ patients
Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists,
Program 3 2000
Play
Audio Below:
I
think that the overview would tell us that we can expect independent
benefits from chemotherapy and tamoxifen in the adjuvant setting.
So my typical discussion with the patient will begin with my questioning
them as to what they perceive their risk of distant metastasis is,
their lifetime risk, and then my subsequent education of the patient
and family about what that risk is, based on tumor size, nodal status,
and other relevant pathological variables. After that we’ll
talk about the magnitude of risk reduction to be expected from chemotherapy
as well as the magnitude of risk reduction to be expected from the
subsequent use of tamoxifen for those patients with ER-positive
disease, and we can get fairly mathematical with our patients. Some
patients prefer adjectives to numbers like high, medium and low
risk – they don’t want to hear the actual numbers –
but if we want to give that kind of information, we can convey it
and help patients make the decision that feels right for them. I
think we, as medical oncologists, should not let patients make bad
decisions, but sometimes things aren’t quite black and white
and when they are areas of gray, patients can make very well educated
decisions to influence their management.
