Tamoxifen and fibroids - questions

Lojo

Hi All -

I know there are some other similar posts about this topic, but I wanted to ask for any suggestions about what to talk to my doc (ob/gyn) about.

This week I went in for an annual gyn visit, and they did a transvag ultrasound and saw what looks like a fibroid, which was blocking their view of one of my ovaries. This is the first ultrasound I've had since beginning tamoxifen nearly 5 years ago. I have no symptoms from the fibroid. When I was originally diagnosed with BC, I had a CT scan that showed I had a 3cm fibroid. It is now (5yrs later) measuring nearly 8cm (on ultrasound), and I got a call from the nurse at the gyn office that said my doc wants me to go in for an MRI. I will be talking to my doctor today about this, but I wanted to ask some good questions.

Any advice would be helpful. The things most on my mind are

1) Will the MRI be able to tell if this is a fibroid or something else?

2) If it's just a fibroid, will they want to remove it (and possibly the whole uterus) if I'm not having any symptoms?

3) If it's just a fibroid are there options to just watch it?

I'm 46, and this spring will be 5 yrs on tamoxifen. I don't think I'm anywhere near menopause, and I don't really want a hysterectomy if it's not necessary, and I really don't want my ovaries out if it can be avoided. My doc also wants me to do an extended gene panel to see if I have any mutations that are linked with ovarian cancer - I'm BRCA1/2 negative, but I don't know anything else about my genetics. There's no ovarian cancer in the family as far as I know, but there is breast cancer (mom, but neither of her sisters), lung (dad and dad's sister - both smokers) and esophageal (mom's sister, brother and cousin -- all former light smokers - but diagnosed late in life (and still chugging along in their late 80s/90s).

Thoughts?