|Entry Date||November 25, 2022|
|Member Name||Katherine Davis|
Patient is 83 year old female referred to high risk clinic for recent right breast excisional biopsy LCIS with Pagetoid features.
PMH: right breast DCIS treated with lumpectomy w/ sentinel node biopsy, radiation, Tamoxifen x5 years completed 2018, osteoperosis (last dexa 8/31/2021 T score -3.9), hypothyroidism, hyperglycemia, HLD, TIA, osteoarthritis
1.) Since previously treated with Tamoxifen for DCIS would you now treat with AI?
Expert Response: 1) I would not treat with an AI. She has osteoporosis. In general we do initiate preventive therapy after age 75 as the risks outweigh the benefits 2) Since she is getting zoledronic acid for Osteoporosis, no need to have a follow up dexa. 3) In general we do initiate preventive therapy after age 75 as the risks outweigh the benefits. 4) Given the advanced age, screenings can continue annually.