Estrogen after BPM, LCIS

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Suze
Suze Member Posts: 186
edited June 2014 in LCIS (Lobular Carcinoma In Situ)

Hi there

I had a PBM a few months ago...they found LCIS and columnar cell changes (not even sure what the latter is!) and other stuff when they went in.

Now my GP wants me off HRT (I had an ooph earlier in the year) bc of the LCIS. He's happy for me to seek a second, specialist opinion first.

I am really disappointed - one of the reasons  I went ahead with the PBM (based on family history - grandmother died at 40 of bc, mother had ovarian followed by bc) was so that I could feel OK about doing HRt, as I am only 41, and I think that menopause w/out hormonal support might just send me over the edge!

I"d be really interested to hear the experience of others re this.

 Many thanks. 

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  • leaf
    leaf Member Posts: 8,188
    edited November 2008

    I'm so sorry you are going through these decisions.

    I don't know of any studies that actually examine the issue of LCIS in HRT users, either before or after LCIS (and nothing worse) was discovered.  (LCIS + HRT gets no hits in Pubmed.)  http://www.ncbi.nlm.nih.gov/sites/entrez?db=PubMed

    So there aren't any direct studies supporting this view.  For example, to my knowledge there are NO studies that show LCIS (and nothing worse) women who take estrogen supplementation with or without PBMs have a higher death rate than LCIS women who do not.

    However, there is a lot of  indirect evidence to support your GP's view, as you are probably aware. Over 90% of LCIS samples inthis study are estrogen positive. http://www.ncbi.nlm.nih.gov/pubmed/9674874  Other studies have found an even higher percentage.

    Since tamoxifen, and other anti-estrogens (AIs) do seem to decrease the incidence of breast cancer in LCIS women,http://www.ncbi.nlm.nih.gov/pubmed/12123540,then it is plausable to opine that estrogen may increase the incidence of breast cancer in LCIS women. 

    Of course, you have already had an ooph, so that puts you in a different category.  I don't think there are any studies that address this directly. 

    This is what Stanford says about columnar cell change. http://surgpathcriteria.stanford.edu/breast/columnar_cell_change/  . It (alone) does not seem to put a person at higher risk of breast cancer. http://www.pathologyoutlines.com/breast.html#columnarcelllesion

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  • Suze
    Suze Member Posts: 186
    edited November 2008
    Thanks, Leaf. It's really hard to know what to do. I keep thinking things like, well, I gave up my nipples, so there's a percent or 2, wonder if I can trade that for HRT!
     
    I think I need to go see my endo who is really knowledgeable about HRT and start there. There are quality of life issues, as well, and  not sure about bone health etc. 
     
    The ooph was March or April this year, so I think I can probably get through reconstruction, take a deep breath or 2, and then tackle this before the 1 year mark. Boy, it just never ends, does it. 
     
    Thanks for the info on that other thing. It's all a bit of a mystery to me, as I really wasn't expecting anything but a clear path report and a diagnosis of 'neurotic'! 
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  • Anonymous
    Anonymous Member Posts: 1,376
    edited November 2008

    Suze--just sent you a PM. Even before my LCIS diagnosis (5 years ago, jsut finished tamox), docs said no HRT due to mom's bc and definitely not with LCIS on top of that. It could increase the risk for invasive bc, that would be undoing what I'm  trying to accomplish with the tamoxifen. So I couldn't take anything after my TAH/BSO--immmediate surgical menopause 3.5 years ago--I just treat SEs  as they come.

    Anne

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  • Jackieb11
    Jackieb11 Member Posts: 16
    edited November 2008
    I too had a PBM after LCIS diagnosis.  My BS said I would never be a candidate for HRT.  I was so bummed about that.  I recently attended a BC conference session on HRT.  I now have hope.  The oncologist spent an hour going over the stats on estrogen and it's risks.  By no means was he promoting HRT however, he did acknowledge the benefits for women suffering with menopause symptoms.  I told him my 5 sisters are all on estrogen and swear it is the fountain of youth. He couldn't argue with me.  I told him that I want estrogen and he said  he would not deny a woman access to it as long as she understands the risks, takes the minimum dosage and does not stay on it for too long.  I left there feeling like I now have options.  Smile  Hope this helps you.
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  • cp418
    cp418 Member Posts: 7,079
    edited November 2008

    http://doctorwascher.com/Archives/4-13-08

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  • Suze
    Suze Member Posts: 186
    edited January 2009

    Hi - just to keep you posted..

    I saw an onc at the end of last year. He is OK with me staying on the estrogen since I have had the PBM. We discussed at length. I was very relieved, since that was one of the reasons I had the PBM. Couldn't imagine staying on HRT with all that risk (and didn't even know about the LCIS at that point) but couldn't live with my ovaries, either.

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