Is it necessary to have Hysterectomy if you have PBM?

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alucasrn
alucasrn Member Posts: 5
edited June 2014 in High Risk for Breast Cancer

I am really leaning toward the decistion to just go ahead and have the PBM, have reconstruction, and get on with my life.  My OB/GYN made the comment that if I have a PBM, he would need to remove my ovaries too; just want to see if anyone in similiar situation.  I have had a Sub-total Hysterectomy but my ovaries have been tested and are producing hormones normally.  

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  • LISAMG
    LISAMG Member Posts: 639
    edited July 2009

    Hi there!

    Are you BRCA positive? If not, why would your OB/GYN be recommending a hysterectomy? If so, you may wish to seek advice from a gyn oncologist who are more up-to-date with BRCA carriers and ovarian cancer risk reduction. Best wishes, Lisa

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  • Mouser
    Mouser Member Posts: 245
    edited July 2009

    Hi --

    I agree with Lisa. Unless you are BRCA positive, there's no reason to remove your ovaries. Ob/gyns (mine included) tend to think there is, but it's not backed by evidence. 

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  • hrf
    hrf Member Posts: 3,225
    edited July 2009

    I also agree. If BRCA positive, then it is recommended to remove ovaries. Otherwise, no identified need unless there is additional family history to consider.

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  • cbm
    cbm Member Posts: 475
    edited July 2009

    Not sure, but ovaries also produce estrogen; if you are opting against Tamoxifen, which suppresses estrogen, then eliminating as many sources of the presumed accelerant, estrogen, as possible would make sense. 

    I had fibroscystic disease but did not get a PBM.  I have just had a bilateral mx and subsequent ooph/hysterectomy.  The ooperectomy/hysterectomy was to shut down as much estrogen as possible (I'm high ER+,PR +) as well as limit ovarian CA risk.  My mother who died of bc at 60 took DES (maybe that's the add'l fam history?).  I'm on arimidex for 5 yrs.  I was post menopausal and haven't noticed any side effects of either. 

    Not sure if it helps, but I'd have gotten the PBM then if I knew what I know now.  Not only because I was in pain from the FBD (and was given estrogen to "stabilize" monthly changes), but also  if I'd known that FBD would make cancer harder to detect.  In my case it hid IDC and a smidge of ILC as well. 

     C

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  • hollyann
    hollyann Member Posts: 2,992
    edited July 2009

    He probably wants to remove your ovaries because you need to reduce as much estrogen as possible with ER+ bc......ER+ bc means your tumor fed on estrogen and the less you have in your body the better...I opted for PBM because of strong family history..I am the 4th or 5th female in my immediate family to have bc........(me, 2 sisters, our mother and possibly our grandmother....Not to mention maybe even a few aunts who died in the 70's that I never knew).......I had a total hyst and ooph because when I went on Tamoxifen it caused large cysts on myovaries and also 2 or 3 tumors popped up in my uterus and I had thickening in  my uterus so my GynOnc said out they go it will be better for you down the road..Less chance of ovarian and uterine cancer as he first thought I HAD uterine and ovarian cancer at the time...Thank God it was B9!.......I wish you much luck and pray for a quick recovery whatever you decide......I also had FBD and my tumor was only found on MRI...........

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  • alucasrn
    alucasrn Member Posts: 5
    edited July 2009

    Thanks for all the info.  I am going to return to my GYN for some answers. He told me that if I have the PBM that having the oophorectomy is indicated in order to completely shut down all Estrogen production. Like I said, I had a Sub-total Hysterectomy about 13 years ago. I really do wish I had just let them take everything. They talked me into keeping my ovaries and cervix...the ovaries for hormone production because I was only 29 and the cervix to keep my bladder from falling (and supposedly the cervix makes intercourse more enjoyable for your husband) What was I thinking? On the other hand, I am still married with great sex:) and after three 9+ lb.babies I still have a working bladder!  Thanks again for all the advice!

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  • Daudine
    Daudine Member Posts: 221
    edited September 2009
    I have no cancer, never did but I chose to have an ovariectomy and a prophylactic bilateral mastectomy last year at 37. I am BRCA1 positive and lost my mother and 2 aunts to BC.

    I don't regret having the surgeries. ..it was tough and lots of complications but I am able to say that I have done everything possible to lower my risks.

    I think the sooner the better, less time you live with hormones better your chances are. But menopause is hard and it is harder when provoqued like in my case and yours.

     I wish you good luck

    Claudine

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  • Annabella58
    Annabella58 Member Posts: 2,466
    edited September 2009

    I had a 2x round with bc, once lumpectomy and rads, 2nd hidden one 1.5 detected only by MRI.

    Both times highly ER+, but no BRAC genetics, no family history.  I am 53.  I am done with childbearing.  I had 5 + years of tamoxifen which can lead to uterine cancer.

    Given all these options and the fact that at 52, I still had to take 7 months of lupron to get me onto arimidex, mind you, never lost the period during any of this!!!!!

    I opted myself (it was not offered) for a supracervical laparoscopic hysterectomy/oopharectomy.  The cervix they leave in, as it offers some protection against prolapse of internal organs.  As long as you get a pap smear yearly, you should be OK> I never heard it was for my husbands' pleasure, and if I had heard that one, I would have shrieked with laughter.  What's next, wash me and bring me to his tent?  Oh my goodness!

    You do have to take calcium and Vit D3 and do weight bearing exercise.  Even then without the protection of hormones (in my case, non protection), your bones may need a drug.  Or not.

    Haven't had a SE at all.  Not from the arimidex much, only creaky and popping joints, offset with exercise.  And the weird stiff feet in the AM

    Good luck to you whatever you decide to do!  Easy surgery, easy recovery too.

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  • rgiuff
    rgiuff Member Posts: 1,094
    edited September 2009

    Alucasrn, 29 would have been way too young to remove the ovaries for no good reason.  The longer you can hang on to them the better.  The loss of hormones with oophorectomy causes instant menopause, which can be very difficult for some women to go through and can have a detrimental effect on sex life, as well as put you at higher lifetime risk of cardiovascular disease and bone loss.  Annie also, you seem to have been pretty fortunate in this regardso far!

    A lot depends on Stage of cancer and whether nodes are involved also, as well as menopausal status in the decision to recommend this type of surgery.  If you have the factors that make your risk for reoccurrance higher,. than this makes more sense.  For someone like me who is perimenopausal, (never know when the next period is coming, last one was in March), and at low risk for reoccurrance, this was never even brought up for discussion, and I'm just as happy to leave it that way.  The perimenopause has caused me enough problems without compounding it with surgery that I fear would make things worse for me.

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  • Notfakejustnew
    Notfakejustnew Member Posts: 29
    edited September 2009

    My oncologist said if I did the bil mx I wouldnt have to do tamoxifen.  If my BRCA was neg then I could keep my ovaries.  I guess this is just a difference in opinion amongst doctors.  But we have to be the best advocate we can be...which means getting info from each other and brainstorming.

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