Hi - Your oncologist will have the exact 5-year survival statistics for you, with and without an AI. Ask for the absolute numbers, not the relative; you want to know "My risk of recurrence with an aromatase inhibitor is 5%, and without an AI it's 10%" - rather than "My risk of recurrence without an AI is double what it is with an AI." If those are the actual numbers (which I doubt, since I totally made them up), then you might say, "I don't want /can't afford to take an AI for 5 years when the added benefit is just a 5% improvement." Or, you might decide it's worth it.

With no node involvement, chemo and a double mastectomy sounds fairly aggressive. I'm guessing your risk of recurrence might already be low, and an AI won't add improve the picture much. On the other hand, since your cancer would respond to an AI (even if weakly responsive to ER/PR, you're still responsive), there's definitely a benefit. Your job is to weigh the benefit/cost - both financial, and physical. Some women do very well on AIs; some have quite bothersome joint pain; you wouldn't know ahea d of time which group you'd fall in.

So, once you have the statistics, look at what kind of person you are. Are you a worrier, someone who second guesses herself? Or are you more of a "make a decision, move forward" person? If the latter, you might lean towards no AI. Good luck - PJH