43y old, on Tamox 3.5 yrs facing hysterectomy or ablation?

tz3

Diagnosed w/ BC @ age 39- bilateral mastectomy, 8 weeks of chemo, stage 1 not in the nodes. Reconstructive surgery,  Started Tamoxifen after, now 3 yrs later having issues w/ heavy bleeding, thickening of endometrial lining, cysts & polyp.  OBGYN advising Ablation or Hysterectomy.  Oncologists supports either procedure.  If hysterectomy is chosen I would be taken off Tamoxifen and changed to the other drug for post menopausal.  Pros & Cons of having either procedure?  based on my age any benefit from partial hysterectomy? keeping either the uterus or ovaries??  Having a hard time making a decision.

ProudMom_Wife

Hi tz3,

I had an ablation about 8 years ago.  Best thing I ever did.  At first, after the surgery for about two weeks, I could not stop bleeding.  My OB/GYN gave me some medication (don't remember what was prescribed), but it shrunk up the vessels leading to my uterus and I have not bled since.  

When I was dx with BC a little over 2 years ago (at age 45) I had discussions with both my MO and OB/GYN about possibly having a total hysterectomy since I was 100% ER/PR+ and I have a family history of both ovarian and uterine cancer.  In addition I was concerned since I no longer bled that if I developed issues from the Tamoxifen how would I know if there was a problem with my uterus.  Both said it was best to leave the ovaries unless there was a medical reason to remove them, and that since I had little if any endometrial cells left in my uterus (since they were all zapped with the ablation) there wasn't much of a risk of endometrial cancer, although there are no studies to back this up just a general theory.  However my OB/GYN wants me see me for yearly check ups and a transvaginal ultra sounds to make sure everything is OK since I am taking Tamoxifen.  So far all has been good.  

So for me the SE of ablation have been non-existent since I stopped bleeding and it really improved my qualify of life.  Not everyone stops bleeding with an ablation though.  The actual procedure was really simple, just had that slight issue, but once that was taken care of I have nothing but positive feelings about having the ablation.

Hope this helps.

rgiuff

I would not remove any parts if there is a less invasive approach available to stop the bleeding.  Removing uterus could lead to other organs being more prone to prolapse and change in orgasm if that is important to you.  Removing ovaries would cause surgical menopause, which could be unpleasant to subject yourself to if you are not in menopause yet, causing all kinds of quality of life issues.  And you can't replace something once it's been cut out of you.