HER2Neu and Hysterectomy???

jpkeeler

Once again, I am back to see what you all can do to help answer a question. You all have always been so informative and helpful. If all goes according to schedule, I will be in surgery this Thursday.
I was dx 10/05 and had a mastectomy, 4 x AC and 12 Taxol and then 12 months of Herceptin. Now, my gyn is suggesting a hysterectomy - anyone else? I understand the ovary removal.........???

nagem

I would ask for a second opinion on this. I'm part of a high-risk ovarian-screening program. The guy who runs the program says just by virtue of having had breast cancer I'm at significantly increased risk for ovarian cancer and suggests I have my ovaries removed prophylactically. But I know that other people in the field feel that's true only if you have the BRCA gene (which I don't). So I'm still mulling over my options and just continuing to get screened. I know that there is ovarian tissue on other organs in the area, so perhaps the suggestion to have your uterus removed is because of that?

saleboat

Did your gyn recommend ovary removal? There are some doctors who think it will reduce the chance of bc recurrance. Do you have a history of ovarian cancer in your family?

In any case, you should understand what the side-effects are, and the risks of the operation.

The Wall Street Journal did an article on ovary removal and the side-effects. The studies cited were not specifically done on cancer patients, however, I have never seen a study that proved that removing one's ovaries would reduce the risk of breast cancer recurrance.

I copied in some of the article. I hope this is helpful to you. Good luck with your decision. Jen

New Data Prompt Rethinking
Of Benefits of Ovary Removal
February 6, 2007; Page D1
Every year, an estimated 300,000 healthy women undergo a surgical procedure to lower their risk for a rare cancer, but new research shows it actually increases their risk of dying from other causes.
The operation is for the removal of a woman's ovaries, called a prophylactic oophorectomy, which is often recommended to women undergoing a hysterectomy. The procedure is commonly recommended to women as a way to eliminate risk for ovarian cancer once child bearing is over. But research shows that a woman is more likely to live longer if her ovaries are left in, and taking them out boosts her risk of dying from a heart attack or hip fracture.
Two recent papers published in two major medical journals examined the long-term risks and benefits of removing a woman's ovaries. A report last fall in the Lancet by Mayo Clinic researchers found that removing ovaries before the age of 45 raises a woman's risk of dying during the next 30 years by 70% if she doesn't use hormone-replacement drugs. An earlier study in Obstetrics & Gynecology showed that removing a woman's ovaries later in life, which is the more common practice, still increases her risk of premature death. In that study, ovarian removal before the age of 65 increased a woman's overall risk of death before the age of 80 by 8.5%.
What's surprising about the data is that it directly contradicts the widely held belief in the medical community that removing a woman's ovaries typically will prolong her life. "We were all shocked when we saw the [data] showing that there was such an advantage to leaving her ovaries in for long-term health," says William H. Parker, clinical professor of obstetrics and gynecology at University of California-Los Angeles School of Medicine and the lead author of the Obstetrics study.
To be sure, the data aren't conclusive. Both reports are based on observational studies, which means the women weren't randomized to different treatment groups and other factors may be influencing the results. In the Mayo Clinic study, young women who had ovaries removed but then took estrogen drugs were just as healthy as women who kept their ovaries. But doctors say many women are frightened about the risk of hormone drugs and often don't take them after losing their ovaries.
Most doctors practicing today were taught that the ovaries don't serve any real purpose after menopause. If a woman is going to undergo a hysterectomy (surgical removal of her uterus) anyway, doctors typically advise women to go ahead and have their ovaries removed as well.
HEALTH FORUM

Should doctors leave healthy ovaries inside a woman's body? Or is it better to remove them to prevent ovarian cancer, even though it can lead to loss of sex drive and put the heart and bones at risk? Join a discussion about ovary removal with Tara Parker-Pope and other readers.
While there is no question that the procedure eliminates ovarian-cancer risk, the fact is most women are at extremely low risk for the disease. Ovarian cancer accounts for 6% of female cancer deaths. But the issue of ovarian cancer is emotionally charged because there is no way to screen for it, and it's usually fatal because it is often detected at its late stages.
The problem is that removing a woman's ovaries to prevent ovarian cancer appears to take a toll on other parts of her body. The ovaries after menopause still produce androgens that the body converts to estrogen. The continuing hormone production of post-menopausal ovaries not only affects a woman's sex drive and mood, but it also appears to offer added protection to her bones and heart.
Based on the Obstetrics & Gynecology report, the benefit of keeping the ovaries far exceeds the risk. The researchers calculated the risks and benefits among 10,000 women between the ages of 50 and 54 who kept their ovaries compared with a similar group of women who opted to have their ovaries removed. By the time they reach 80, an additional 838 women in the no-ovary group will have died of heart attacks and another 158 will have died from hip fracture compared with women who keep their ovaries. However, only 47 women in the no-ovary group would be saved from ovarian cancer.
Women with a strong family history of ovarian cancer obviously have more to gain from ovary removal than women with a strong family history of heart disease or osteoporosis. Dr. Parker says the study isn't perfect, but it should at least prompt doctors to have a more meaningful discussion with patients about the full risks and benefits involved in removing healthy ovaries from a woman's body. "This is at least a subject for conversation between patient and doctor," says Dr. Parker. "But that conversation often does not happen."

sassyone

I think the advisability of ovary removal or hysterectomy would depend more on your hormonal status. Are you ER and/or PR positive? If so, removal would be more advisable because your cancer feeds on estrogen. If hormone negative, this is not the case.

Sassy

saleboat

There is no medical evidence to support the removal of a woman's ovaries after treatment for early-stage non-BRCA breast cancer. Proceed with caution, because there are risks to such a surgery.

coachvicky

I realize these posts are in 2005 - 2007 but they sure have helped me in 2017!

Coach Vicky