What should a person with breast cancer IV take after tamoxifen and aromasin. Arimidex femara or faslodex (fulvestrant)?
Treatment options. For stage IV breast cancer- if the cancer progressed after tamoxifen and aromasin- depending on several factors such as how much cancer burder, involvement to visceral organs, overall condition etc- the options would be- faslodex; combination of Aromasin (exemestane) and evorilimus (based on recent randomized clinical trial) or chemotherapy. Discuss further with your oncologist- which one for your case.
Chemotherapy? If stage IV breast cancer is no longer responsive to tamoxifen or exemestane, it is unlikely that additional hormonal therapy would be of benefit. The next form of systemic therapy should probably be chemotherapy. If the cancer is her2/neu positive, either chemotherapy with trastuzumab (herceptin), or trastuzumab alone could be given.