Er positive, birth control, tamoxifen

BeatriceT

dear all

I'm 35 this year and was diagnosed in feb 2017 w breast cancer stage 2.

I was tested er positive pr positive her2 negative.

I have completed my chemo 3 weeks back and was told by my oncologist that I need to be on medication tamoxifen 5-10 years. I was depressed. She mentioned it was due to my estrogen er is positive and the medicine will block the estrogen level.

I went back and recalled that i have been taking birth control pills that contain estrogen and stopped only when I discovered I have cancer.

I have a question:

I suspected is because of the birth control that cause my er positive. Since then I have stopped taking, can I request for testing of er again? If results is negative, does it mean that I need not take the medication?

Thanks all in advance, love.

MTwoman

Beatrice, welcome to BCO! Many women in the US take hormone-based birth control pills and the percentage that get breast cancer is low, so try not to place blame on yourself for that. Now, when you got a result of ER+, it was the cancer cells that were tested, not the rest of your (non-malignant) body. Once you've had your surgery and completed your chemo/rads, you shouldn't have any more bc cells in your body (that's the hope anyway). So when you say "can I request for testing of er again", they don't test the amount of estrogen created by your body, they specifically test bc cells, which you shouldn't have anymore. Read more about the hormone receptor status here: http://www.breastcancer.org/symptoms/diagnosis/hormone_status/read_results

Tamox is intended to reduce the risk of recurrence or another primary to your remaining breast tissue. Women who have had ER+ bc (which means that the bc cells were "fed" by estrogen, naturally occurring or otherwise) are not typically given any estrogen/progesterone medication ever again. In my case, my dcis was ER- and I still found that no medical provider would ever prescribe an estrogen-type medication for me. Even when I wanted to take a phyto-estrogen (black cohosh is an herb known for it's plant based estrogen properties) for menopausal symptoms, all of my medical providers recommended that I not take it.

It sounds like it might be helpful for you to return to your MO and have a discussion about what motivates you to want to stop your Tamox and what other types of birth control options you have (either with your MO or your ob/gyn).

gb2115

MTwoman was spot on. They are different things, so while you wouldn't want to go back on birth control again, having stopped taking it doesn't negate your need for tamoxifen. Tamoxifen is standard care for ER+ cancer. Tamoxifen blocks estrogen receptors on the cancer cells, which helps prevent the cancer cells from dividing and growing. That is a good thing!

Just FYI, I am 39 and have been on Tamoxifen since late February and haven't had any problems with it that are of consequence to me. My periods are now 6 weeks apart instead of 4, but that's ok. I get hot flashes here and there--they coincide with my cycle. I think it amuses my husband, because I will start taking everything off and complain of heat, and then 5 minutes later complain it's too cold because I was sweating so much (I'm normally cold natured anyway). But I personally don't find the hot flashes to be a big deal.