Uterine biopsy ordered, really?!

hummingbirdlover

I've been on tamoxifen for about 15 months now and have done ok. I've had fairly regular, but really light periods. I skipped the month of January and then had a super light period February 1. It's now the 20th and I'm having another period, or just some light bleeding. So, I called ob and she wants to do a uterine biopsy. Really? That word causes extreme anxiety, I'm sure you all can relate. I'm trying not to panic but it's hard. Just wondering if there are others out there who are going through this now, or have in the past? Hoping it's just tamoxifen related and nothing to worry about. I'm glad she's being cautious and thorough but seriously, sometimes I think "just take it all out"!!

Thank you

ShetlandPony

It is well known that tamoxifen can cause menstrual irregularities. Is there a particular reason the ob is recommending a biopsy? What does your oncologist say?My doc told me that the small risk of endometrial cancer with tamoxifen is really only a concern for post-menopausal i.e. non-menstruating women.

hummingbirdlover

Thank you. I haven't talked to oncologist yet. Last time I saw ob she said to call if I had any irregular bleeding, so I called and she scheduled the biopsy.

Bounce

Hello hummingbirdlover

I too had to have a biopsy last June and it threw me into a very unhappy frame of mind.

Every aspect of the situation distressed me and I went a few different kinds of crazy all at the same time.

To cut a long story short the biopsy was OK. I told the gyne beforehand that I wasn't happy about doing it and he understood my anxiety. He was calm and competent and helped me get through it without drama.

It was not painful like being cut but did cause a cramping type of pain for a few minutes.

The results were OK and I wish now that I hadn't gotten so worked up about doing it.

So this is just to let you know that I understand how you feel and to encourage you that the biopsy is doable and hopefully the results will be fine and that you just have a careful OB who cares about you.

hummingbirdlover

Thank you, Bounce! You'd think I'd be somewhat immune to the fear factor after all of this, but I'm not. I appreciate your comments, and I am trying hard not to borrow worry before I have to

Asante314

hummingbirdlover: sorry you are going through this. just sharing my story and good ending with irony. apologies for long winded story here:

I met with my breast surgeon for the first time last year (the day before my birthday) and was told I needed a pesky papilloma removed. Well my period started the next day and basically continued for 2 months, just light barely spotting... so I went to gyn who did an endometrial biopsy. I think that is likely what you are going to have as a first line. It was a simple procedure. only a pinch more than a typical pap smear, and over in a few seconds. I had a little cramping later, but nothing I bothered to take anything for. some diagnosis of simple hyperplasia without atypia. she put me on a few courses of prednisone. However then the MRI the breast surgeon ordered found enhancement and led to subsequent biopsy and LCIS dx and then scheduling of removal of the papilloma and a lumpectomy. Back and forth conversation about continuing the progesterone or not. so I stopped it the day of my surgery in May, 2 cycles shorter than the gyn had planned.

surgery went well w no further dx and my period returned on its own to normal for a few months.

August went to gyn, routine yearly and repeat endometrial biopsy as she had planned dx "normal". Again the in office endometrial biopsy was simple. Even knowing ahead of time I did not take ibuprofen before going in... but they say it does help some women who tend to cramp, so ask your gyn...

At the end of summer I spent a wonderful 2 weeks traveling in Africa, and my period started and then persisted again w the barely spotting routine... called gyn when I got back and she said to give it a few weeks, maybe travel threw things off.

September: surgeon wanted MRI repeated post-op due to level of enhancement seen pre-op. Scheduling issues w MRI causing cancelation, great anxiety for another week.... MRI continued to have several areas of enhancement that the BS is just not comfortable with.

Surgeon and MO based on family hx (sister w stroke at 47y, dad at 50) autoimmune issuesand and adding recent gyn issues said no to tamoxifen. Several BS/ MO opinions later all rec BMX. So several appointments finding the right PS, scheduling it all for next month (March 2016).

Well, being a bad (gyn)patient with too many other issues/ appointments/work and family... finally got around to calling gyn back to let her know I was still having some spotting. She cycled progesterone again (BS said ok) and scheduled a D&C.

D&C completed for New years eve... anesthesia always my enemy, but otherwise no pain following at all. And I was up cleaning cabinet door fronts on a ladder the next day. (prob not rec, but I wasn't lifting anything)

Final diagnosis: healthy, likely having some cycles as I get older (47) without eggs (anovulatory) and premenopausal. Period has cycled normally without progesterone since the D&C.

The funny ending to this to me personally, is the gyn said most likely it is all from STRESS!!!!!!. So in the midst of dealing with LCIS/ scheduling BMX, stress at work and home, my body thought "dysfunctional uterine bleeding" would be a helpful response to let me know I am stressed.

So now I had my preop appt w BS this week, ironically the day before my birthday. Period started the day after my birthday... and hoping this year it stops, and with my short cycle, is likely to start again on post op day 3, joy.....

Please follow up as rec, I was thankful to have a repeat normal endometrial biopsy, and then a confirmatory D&C "cleanout" which was also clean.

Wishing you a diagnosis of normal findings and just typical response to tamoxifen, and then just use that as justification of treating yourself to something that makes you smile, breathe deep and love life.

SelenaWolf

Your doctor is simply being thorough. It's nerve-wracking, but it's a good thing.

ChiSandy

Before I finally reached menopause, my OB-GYN was concerned about my severe cramps, the length and volume of my periods and by my difficulty holding on to early pregnancies (i.e., inability to implant) both before and after I had Gordy. Since I'd previously had endometritis after my C-section (too much time had elapsed after breaking water and going through a trial of labor), he was wondering about whether I had developed chronic endometriosis. So he did an endometrial biopsy and transvaginal ultrasound to rule out cancer. It was painful but only for the 30 sec. or so it took--had a little spotting but no cramping afterward. Dx was adenomyosis--multiple small fibroids growing into instead of out from the endometrium. Disappeared when my periods finally did.

Your doctor is just being very thorough, since uterine cancer is an uncommon but known risk of tamoxifen therapy.

hummingbirdlover

Thanks so much for your replies! I called and whined about having to wait an entire week for the biopsy so they moved it up to day after tomorrow. I just want to get it over with. Your experiences are very comforting, misery loves company I suppose. This board has been a life saver for me, thank you again

Bessienurse

I am staus post DCIS right breast with wedge resection, radiation and Tamoxifen x 41/2 years ago. 2 weeks ago I saw my oncologis for my routine and thought I may have a urinary tract infection, but it wasn' t really giving me symptoms of one. She thought maybe it was a kidney stone, but I didn't have pain. She ardered a CT scan with contrast of my abdomen and pelvis to rule out stones. Meanwhie I noticed the blood tinged urine was not from a uti, it was vaginal. Well the CT scan confirmed that the lining of my uterus was thicker than normal and my uterus was larger than normal considering I have been post menopausal for 10 years. She ordered a transvaginal ultrasound which confirmed that the lining of my uterus was thicker than normal. She said it was from the Tamoxifen, shich I had stopped 2 days before the CT scan. Mind you I haven't had scant amounts of bleeding,and slightly tinged vaginal discharge at times, or not at all. A little crampy, otherwise, no symptoms. Anyway I have to have an endometrial biopsy and am consulting with a GYN on Tuesday. I have read so much being a nurse and am absolutely terrified of the biopsy results. Hopefully its hyperplasia, but from this point take it all out! I fear chemo and radiation. Hopefully I have caught this real early because this is the first time this has happened. Sorry for venting so much , but I know someone has been in my situation, I welcome any replies. I'll keep you updated. Meanwhile I am an absolute insane person to live with right now.

Moderators

Bessienurse-

We're sorry you find yourself here but we're glad you've found us, and hope you find the support and encouragement you need as you go through this! Vent away, that's what we're here for!

Please do keep us posted, you'll be in our thoughts.

The Mods

Jelson

I was diagnosed with endometrial cancer 4.5 years into taking tamoxifen - post menopause - my uterine lining kept thickening - had 2 d&c's then actually had slight brown then pink discharge - d&c found cancer, had total hysterectomy laprascopic/robotic - the cancer had not penetrated the uterine wall - caught so early! stage 1a. about 8 months from first symptoms to hysterectomy. no rads or chemo. I think you will be fine even if not benign - good luck

hummingbirdlover

BessieNurse, I just wanted to share with you that I completely understand what a tail spin something like this puts you into. I've been a wreck this last week! I had my endometrial biopsy on Wednesday and the Doctor just called and the results were fine. Hooray!!! Nothing there that looks concerning, so she thinks the extra spotting is just a fluke and/or related to the tamoxifen or perhaps (As Asante 314 stated above)...related to STRESS, of all things. She also told me at the appointment on Wednesday that even IF cancer cells were found there, there was still no reason to panic, that it would just be a surgery away from being gone. So try not to worry and I hope everything turns out ok for you. Let us know what you find out.

Anonymous

Do the biopsy.

I had bleeding, had the biopsy, and found out that I had uterine cancer after 5 years of Tamoxifen. Six months after my hysterectomy, I found out that the uterine cancer is back, and is now metastatic. Maybe if I had found out about the uterine cancer sooner, I would have a different prognosis.

Don't let anyone tell you that uterine cancer is no big deal. A full 20% of those diagnosed with uterine cancer will die from it. Don't fool around and become a lousy statistic.

Asante314

humingbirdlover - glad to here your endometrial biopsy was normal!.. Stress, like we need that!. Plese however keep in touch with your gyn, and go back if it recurs. It is not worth the risk of ignoring!.

Bessienurse: sorry you are having this issue as well, I am hoping your biopsy was clear as well.

sorry for late reply, forgot to tag this to my watched threads list!

asante

Pokemom1959

I went through the same thing. I hadn't had a period in a year (turns out I'm still peri-menopausal) and had been on tamoxifen for about 8 months. Then I had a normal period. They made me see an OBGYN who said yep, we're doing a uterine biopsy. I consulted Dr. Google, scared myself to death and loaded up on drugs the day of the procedure (I took a Xanax, a Lexapro and 800mg of Motrin) - I was so loopy during the procedure I don't even remember much, other than the fact that it wasn't nearly as bad as I had anticipated. Some mild cramping while she was getting the sample, but that only lasted about 10 seconds. Just take some pain melds before you go and if you have some, some anxiety meds. You'll be fine. My biopsy was negative thank goodness. Just another indignity we Breast cancer survivors have to suffer!

Tomboy

Pokemom, I was looking at your stats.! Don't tell me they did a lumpectomy the same day they started radiation?!?! And then waited a month to do the sentinel lymph node ?!? That seems a little whacked to me, but glad you are here, and glad they found it early.

PatMom, I am so, so, sorry that that happened to you. Was there anyone watching you, during the years of tamoxifen? I am asking, because even though I am well past menopause, I had my bout with arimidex, and femara monster, and have now been on tamoxifen for over a year. And so, before I started tamoxifen, I still had a large suspected leiomyoma of the uterus, fibroids, I guess, several of them. At first, they made me do a transvaginal ultra sound, the first time I tried tamoxifen a couple years ago. I really didn't like the side effects of any of them, but understood that I must. And then, like again four months after starting. What I am having a problem with, is that after being on it for a whole year this time, nobody wants to look at me to see if anything has changed. I am talking specifically about the place of treatment, where they have all images and info. And it burns me up! I really don't want another cancer. I have tried exactly one other gynecologist, and it was not something I will do again. I really would like my treatment center to look.

wallycat

I also had a biopsy while on tamoxifen. My endometerial lining got to 11mm and that is at the cusp of concern. Under that, and "they" typically watch and see. Interestingly, I joined an early ovarian cancer study which included trans-vag and my first time going, they found thickening in the uterus, possible polyp. Emailed my gyn in WI (whom I trusted the most) and she suggested a hysteroscopy vs. simple biopsy. If there really were a polyp, they could do the removal then to. She also told me 5% risk of finding cancer because of the tamoxifen, so I was bracing myself. The new gyn out here in WA (she is a disgrace to doctors everywhere in how she treated me) did this in an outpatient setting using full anesthesia. Fast forward...THREEE polyps were found. NO cancer.

You're fortunate to have a caring and thorough doctor. Hope it all goes well for you and so sorry you are dealing with this.

Curlykat

I've been on Tamxoxifen since July and went in for my annual last month. My GYN thought he felt more fibroids, so he ordered an ultrasound. One benefit of Tamox for me, is that I have not had ANY menstrual cramps since I've started it, and that's with endometriosis and fibroids. Anyway, the ultrasound did identify more fibroids, but they're small. However, my doc didn't like the looks of my uterine lining (I was just before ovulation at that point), so he scheduled a return ultrasound after my period. I'll do that on the 22nd of this month. When the nurse called to tell me that my pap was normal (my mom died of ovarian cancer, so for the past 3 years I've been having annual paps and CA125 checks), she also let me know that if he didn't like the 2nd ultrasound, he'd want to do a biopsy. Apparently, Tamoxifen can cause endometrial hyperplasia.

I'm not worried about it, because if it's problematic, I'd rather find out before it becomes anything more serious. I'm very grateful to have a doctor who is watching me very closely.

Carrie37

I'm a little panicky right now. I am on tamoxifen for about 8 months now. Haven't had my period since April 2015; one month after I started A/C chemo. GYN said I should contact her asap if I started bleeding. I had my TE's exchanged for implants two days ago as well as some fat grafting from my abdomen/tummy. Now, today, I get my period for the first time in 15 months. Of course it is a holiday weekend so I'll call her Tuesday. I'm sure I'm worried over nothing but what could it be?

hummingbirdlover

Carrie, what did your doctor say? I had the biopsy and everything came back fine and when I talked to my MO about it, his exact words were "I think this is your body going through menopause while on tamoxifen" and he didn't seem overly concerned. It's something to monitor definitely but try not to panic. I know, easier said than done

Carrie37

I had the biopsy today and should have results by Monday at the latest. My MO said I should have it done just to be on the safe side. My GYN who did the biopsy said afterward " I got a small tissue sample which is good because there shouldn't be a lot of tissue there." Waiting sucks. Thanks for asking.

Pokemom1959

Guess it's been awhile since I've been here!

Yes, they did intra-operative radiation during the lumpectomy. It was a clinical trial program. One shot of radiation during the surgery and I was done with the radiation treatment - it is supposed to be as, if not more, effective than the 36 external radiation treatments and far less invasive/side-effects.

The reason the SNB wasn't done until a month later was because I was originally diagnosed with DCIS. When she got in on the lumpectomy and later got the pathology report, she found out I had a micro invasion of IDC so just to be on the safe side and make sure it had not spread, we did the SNB