ovary removal instead of tamoxifen

I will be doing the same thing, I am 100% estrogen receptive and my oncologist feels having the ovaries removed and going on Arimidex (think that's the one he said) rather than the Tamoxifen is a good option for me. I was very concerned about the possibilities of uterine cancer on the Tamoxifen. The downside to going this route is the bone loss issue though, there's always some kind of trade off.

I did full ooph/hyst (ovaries/tubes/uterus) because of a solid mass in one ovary. Everything turned out OK, thankfully but I went into immediate surgical menopause and it is not fun at all. My onco did tell me that it was the best treatment/replacement for tamoxife/arimidex but she only told me that after the fact because she didn't want to encourage me to do it unless it was really necessary.

If you are not BARC+ and have no complications with ovaries, you might want to think this through a bit and have second opinion. I'm surprised your Dr.s are encouraging you to this! It is irreversible and with nasty menopause (many times stronger than regular menopause) and other side effects.

These are the side effects I'm going through right now: Vaginal atrophy, dryness, lack of libido, very painful intercourse, headaches and very strong hot flashes by the hour.

But everyone is different. I might be having it worse than others. I'm not, however taking any medication or doing radiotherapy because I did bilateral mastectomy and ooph/hyst and my diagnose was caught in very early stage.

This is a reality and something many women with breast cancer either do because they have no option or do because they DO have an option. I expresed concerns about taking Tamoxifen due to the risk of uterine cancer and that is when my Dr. discussed this option with me. I also have ovarian cysts that showed up on my scans in November so there are added benefits for me there to avoid potential future issues. Even if that wasn't the case I would still be opting this route. I'd rather risk some sexual side-effects and strong menopause than uternine cancer. We are all different and we have to make the choices that are right for us and that we feel we can live with, for me this was the choice I felt I could best live with. I'm not sure what a second opinion would do for me, my doctor is not forcing this on me nor is he telling me this is my only option, is is just ONE option and I appreciate him telling me what all my options are. Now, if I hadn't researched the pros/cons of each of these options and discussed those in detail with my doctor before making a decision than shame on me. I would be more upset with my doctor is he had not told me there were other options besides Tamox and then I ended up with uternine cancer and only then found out I could have done things differently.

leklovesskr - the reason for the Arimidex is to block the other estrogen that is produced outside of the ovaries (from fat and such). Yes, Arimidex is for post-menapausal women and after I have my ovaries removed I will be considered post-menopausal (surgically induced of course); I'm actually in chemo induced menopause right now and have been for a couple of months. For me, being 100% estrogen receptive my doctor wants to put as many estrogen preventing/blocking plans in place as he can. I was also lymph node positive so I have a higher chance of rogue cells somewhere else in my body so as little estrogen as we can have in my body the better.

gsg - I am also stage IIa, grade 2 IDC, I had one lymph node involved, but very similar diagnosis otherwise. So happy to hear you are doing well on the Arimidex, that's very encouraging.

friscosmom:  Thus far, my bone density scans have been perfect.  I just broke my leg 2 1/2 weeks ago.  Anxious for my next X-ray...hoping Arimidex doesn't slow the bone healing.  Orthopedist said no way to predict...so we shall see.  In the meantime, I'm eating plenty of bone-strengthening foods, which isn't a bad idea for anybody taking Arimidex.

Good luck to all. 

Have you considered taking Tamoxifen to see what side effects you have before putting yourself into surgical menopause?  I have been on tamox for over a year and while I had hot flashes the first month or two, I have experienced no other effects.  I started taking this when I was bald, I have never heard of the hair loss side effect but I can tell you my hair is super thick and lots of it.  I continue to have periods and I don't have any problems with depression.  I wouldn't even know I was on it at this point.  I think everyone is different, you might be pleasantly surprised at how little side effects you may have.  Please don't be scared off by some of the posts you may see, there are many women that blame Tamoxifen for everything and it can scare the women who are making their decision on whether to take it.  The risk of uterine cancer is so minimal that I didn't factor that in at all.  Anyway, just my 2 cents that you could always try it and if you have problems with it, stop taking it and get the surgery.  That way you would know whether you made the right decision. 

Investigated the same question. My oncologist and surgeon are female. The consensus was that SE of uterine cancer small and it doesn't outweigh the benefit of tamoxifen.  They did not recommend removal of ovaries.

There are so decisions to make when you have cancer!  We can never be sure we are making the right one I guess.  I was diagnosed with a very small tumor in 2003 when I was 44 years old.  I had a lumpectomy, radiation and took Tamoxifan.  I thought I was done with it.  A year later I was dxd again.  Chose bilateral masectomy and chemo that time.  No more Tamoxifan because they figured it didn't work the first time I took it.  Had a laproscopic full hyster when suspicious cells were found in my uterus and cysts on my ovaries during my yearly exam. It was easy for me. Was up and ready to head back to work a week later but had to wait for three weeks.  Took Effexor to deal with the hot flashes. I have BC in my family and I was warned of an ovarian cancer link.  Figured I did not want to deal with that too.  Good luck to you!

3 reasons

1)A study came out that said women who didn't have their periods after chemo had better outcomes

3)My friend (who is on  here) just got diagnosed with ovarian mets after being told it was extremely rare. She had dcis, then got dcis again then got sage 3 bc and now mets.

3) I have been on tamoxifin for 6 weeks and already have some damage to my uterine lining which showed up on a vaginal ultrasound that I requested b-c I wanted some peace b-4 going in for my oomph that everything was ok.

Hi,I had no choice but to have my remaining ovary removed.Shortly after my MX I developed a DVT and they could not give me the tamoxifen because of side effects of blood clots.The ONC and BS decided to take my remaining ovary as trade-off. I had that removed 5 weeks after my MX.I have the nasty side effects from losing my ovary like the insomnia,hot flashes,dryness etc.BUT I would rather suffer through these than risk taking tamoxifen and get another blood clot.My ONC said I would benefit the same by taking my ovary as takign the tamoxifen for 5 years without the side effects from the tamoxifen. It has been almost 6 months and I am dealing ok with the surgical menopause.the worst is the insomnia and vaginal dryness.But I look at it like cancer would be worse.

I am frankly shocked that this was recommended for DCIS.  I am researching the question of having an oophorectomy right now (I finished five years on tamox and and am now on zoladex and arimidex) and I'm finding this a very difficult decision.  The reason this is so difficult is because there are studies indicating that removing ovaries shortens your life span.  (Not true if you have the BRCA mutation -- in that case it lengthens your life span).  The ovaries do more than produce estrogen and there is some feeling that these other functions protect life and health.  Now I was stage IIB and it may be worth it for me to have my ovaries removed, even with these other issues.  But I am seriously concerned about the ultimate downsides and may just stay on zoladex for a few years.  This is an incredibly difficult decision for me.

But if I had DCIS the decision would not be difficult at all.  Seems to me the risks of having ovaries removed are far greater than the risks of tamoxifen.  Most women do great on tamoxifen.  I was on it for 5 years and after the first six months had no side effects.  I am really concerned about doctors that are so blithe about yanking out women's ovaries.   

For DCIS, I've heard of tamoxifen being optional in some cases, but I've never heard of oophorectomy being recommended.  This is a drastic and irreversible thing to do to your body.  I've had 2 friends with breast cancer who did this {their cancers were more advanced} Stage 2.   Both of them told me it's caused big problems with their sex lives because of the vaginal dryness and loss of sensations, as well as problems with bone loss.  I would compare it to a male having his testicles removed and as others have mentioned, I doubt that doctors would be so quick to recommend that to a male with a hormonal driven cancer when there are medications that have a less drastic effect and still take care of the problem.   

I have been on tamoxifen for over 18 months and although I have hot flashes, I was already having them anyway due to being perimenopausal.  Most other side effects aren't that bad.  And the risk of uterine cancer is 2 in 1000 as compared to 1in 1000 in women not on tamoxifen.  The risks of dying earlier from other causes are increased with oophorectomy.  

Please, don't just jump into this surgery when you have other options.  As mentioned by others here, you can always try the tamoxifen and then stop taking it if it causes problems.  An oophorectomy can't be reversed.  Research the pros and cons, read about other's experiences, go to other websites.  Read about what the ovaries do for your body, even after menopause.  With DCIS, you have better options.  If I had DCIS, I might not even be taking tamoxifen, I might just be doing natural alternatives, but I was Stage 1, so I'm taking tamoxifen just as a little extra insurance.

I agree with not jumping into Dr.s recommendation for ooph. If I had to do it over I'd not have done it because it's been REALLY dificult with side effects listed by some of the ladies above. I had  benign mass in both ovaries and large fibroid in the uterus but I still don't think it was worth removing ovaries. What if you did a through pelvic sonogram/exams now as a starting point, try tamoxifen for 6-9 months, follow up with another pelvic exam, and make your decision base on any alterations or if in fact you'll have serious side effects from tamoxifen.

Also, most of the time, when you remove ovaries and tubes, they recommend for uterus to be out also since it doen't have any other function in the body other than child baring. In my case they did total hysterectomy - removal of ovaries/cervix/tubes/ uterus. Dr' explained to me that it would be wise to remove everything since both ovaries were coming out.