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Re: Gyn: Gail Model 1.9From: Garry Siegel (garrys@mindspring.com)Wed Apr 26 20:16:30 2000
At Tue, 25 Apr 2000, Efrain Ramirez wrote: > >55 year old female patient, on Prempro 2.5 x 5-6 years, excellent >results; good lubrication, no symptoms, Bones Densitometry Ok, lipid >profile Ok, Gail Model,1.9 (no mistake on that) Yearly mammograms ok, >endometrial stripe ok. >What next? > Great case to discuss. One one hand, if it ain't broke, don't fix it. On the other, she clearly is a candidate for Tamoxifen. For all we know (pending the STAR trial), she might benefit from Raloxifen or Tamoxifen. Our "horse sense" tells us that their likely is cross-over, ie that Tamoxifen is good for the bones, and Raloxifen is good for the breasts, but we've not proven that yet. I would lay this all out for her, especially the fact that we don't have the long term stuff in yet, and let her decided. Me? I would leave her on Prempro for now, until more data (ie longer observational trials) are in. Garry
-- Garry E. Siegel, M.D., F.A.C.O.G. Roswell, GA Private Practice
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