DCIS- cancer or pre-cancer?

I think I would be getting a new gyno!  yikes!  Even though it's stage  cancer, it's still CANCER.  Or, at least how my oncologist explained it.   If the oncologist felt that meds weren't needed, I would go with that.  And WHY would you go on estrogen, if your cancer was ER positive.  I would get another opinion, and perhaps complain!

Mommyathome,

There was a huge research study in the 1990s called the HERS Study that showed estrogen does not prevent heart disease. Women with heart disease who were started on HRT actually had a statistically significant higher chance of dying of a cardiac event than women with heart disease who were on a placebo. I had an interest in the topic because I was in my 40s at the time and there was a family history of early heart disease among males and females in my family.

Hi Mommyathome, I answered you on another thread and I totally agree with the others that I'd be getting a second opinion from another Gyno or indeed from your team. 

This Gyno has neither a good attitude, or much knowledge about BC.  It isn't unusual for specialists to be blinkered about all, but their own field of study. 

I can imagine just how upset you must have been when she was so cavalier and wrong! If it were me I would print out the info about DCIS available here, send her a copy and kick her to the kerb!

I wish you all the very best and hope you find someone who has your best interests at heart, to advise what you should do. Take care. 

Holy cow Mommyathome! I live in CT too...what is that gyno's name (PM me!) so I make sure none of my friends ever go there! I have an awesome gyno who would NEVER suggest estrogen to me after having dcis. I was there this morning for my  yearly pap and I told her how hard the aromasin has been on me and she said "Yeah, but since your BC was so highly ER/PR+, you absolutely have to try to get through those five years!"

 Talk about singing a different tune than the one you saw! I am post meno and she never told me I was going to die of a heart attack if I did not get some estrogen. As a matter of fact, we discussed why my pap was a little harder today than it had ever been and she said "well you vagina skin is thinner due to lack of estrogen from both aging and the aromasin, but the drug is more important!!"

Hugs and kick that idiot to the curb!

aromasin is a different category of med that is given to woman who are in menopause and to prevent the cancer from returning.  Works in a dif way than tamoxifin which is given to woman who are still having periods

some docs actually put women into menopause so they can take the aromasin (or other AL)

regardless of which it is an important part of the treatment...I was DCIS, took my AL for 5 years and now, proudly cancer free

key word in dcis= carcinoma=cancer=new dr needed

When I supposedly has dcis only I had two breast surgeons call it pre cancer. Nope.  Sorry. A cancer cell is a cancer cell. Don't sugar coat it. 

I am so so sorry you had such a rude ob/gyn.  That was so cold hearted and callous for her to talk about a mastectomy like that. I also had one that told me that DCIS was not cancer. She sat up higher in her chair, stuck her chest out, argued with me and I shot back with the information I know and that the head of the cancer clinic in the medical center she works in considers DCIS cancer. Then I told her if that was her opinion, she was fired. I walked out the door and never went back.

The next ob-gyn was wonderful!

Anyway, I would write down all the questions I had.

With having your ovaries removed, according to Mayoclinic.org, there is a chance of osteoporosis, cardiovascular disease and other problems (http://www.mayoclinic.org/diseases-conditions/menopause/basics/complications/con-20019726). I read the whole information on Mayo's menopause information pages. 

The National Institute of Health (http://www.nia.nih.gov/health/publication/menopause-time-change/postmenopausal-health-concerns) is also a good read on menopausal problems.

After my ovaries were removed and a total hysterectomy, the nice ob-gyn wanted me to have a bone density scan a year later. It showed some bone loss. After about a 7 month period of being on Prednisone, it was a little worse, but they also had me on Allendronate for osteoporosis. So there are treatments for it should one develop it. Weight bearing exercises on the legs also helps with osteoporosis. 

As a side note, just because things are possible to develop after menopause, it does not mean that anyone is guaranteed of those problems.

ALL my doctors said since I had a BMX with no reconstruction, I didn't need Tamoxifen or the other drugs for menopausal women. I do not know if it is different if people had reconstruction.

I like to research on the internet in ONLY credible websites to learn about the basics of what I am going through. If I can't do it without freaking out, I stop. I also write down all my questions and slow my brain down. Slowing my brain down when I am upset isn't always easy.

I wish you the best on your quest.

I would ask a medical oncologist about the Tamoxifen/Aromasin issues.

My DCIS was ER+/PR+, so I can’t go on any hormone therapy.
I did meet with an oncologist who told me that it was my choice whether or not
to go on Tamoxifen, but since the DCIS was taken care of with the mastectomy, I
chose not to go on Tamoxifen.

I have a new breast surgeon who’s worried about recurrence
and cancer cells lurking elsewhere and why I wasn’t put on Tamoxifen as
precaution. I’m starting to doubt why I didn’t err on the side of caution.

My GYN is pretty awesome. Hope you find one who has
better bedside manners.

Hi gabriellaM,

Removing or blocking estrogen in the body is the single best weapon against recurrence and/or a new primary. It protects both of your breasts. Your body likes to make cancer and already has as evidenced by your diagnosis of DCIS. Also, you are BRCA+.

Frankly, I am surprised they did not prescribe tamoxifen (or an AI if you are post-meno) for you but your doctors apparently think you can forgo it. I had 5mm DCIS with clear margins and had rads too but due to >95% ER/PR+, I have been told I absolutely should take it!

I would think adding more estrogen is a dicey proposition despite your low odds since you are more than double the average population more likely to get breast cancer. I would not chance HRT...not on a bet! It is of course your choice to make and some women feel they absolutely cannot live without it. It is no picnic on the AI, but I am determined to get through my time to up my odds of no more BC!

We live with what we choose and I know that I am comfortable with my choices. I had a lumpectomy and so many choose MX so we each make choices we feel are best for our own situation which is exactly what you should do! I wish you the best whatever you decide as in the end, it is up to us how we accept or reject treatments proposed.

Thanks for your responses April and Ariom!!

I had a bilat mastectomy which is why tamoxifen wasn't recommended. I believe that studies of women with DCIS who have bilat mastectomy show no improvement in outcome if they take tamoxifen, which is why it is not recommended (since risk of recurrence is only 1-2% after BMX and tamoxifen reducues that risk by 35%, the risks of the drug are considered more significant than i's benefits).

I would definitely not want to take HRT past menopausal age -- I believe menopause is natural and what our bodies are meant to do. However, surgical menopause at 46 (my cycles are still regular like clockwork) is an unnatural removal of hormones that may still have a role to play in my body (of course my ovaries are a ticking time bomb and must come out!!) If I were an average women (risk of breast cancer 12%) who needed my ovaries removed prior to menopause no one would think twice about prescribing HRT until I am 50. My breast cancer risk is currently below average due to my surgery (I know it's kind of hard to believe this once you've been diagnosed with DCIS, but statistically, at 5%, that is the case). Psychologically I can see why people feel they want to do everything in their power to prevent recurrence but I still think it's illogical based on the statistics as I understand them. I'm just trying to understand if I'm missing something about the risks of recurrence after bilateral mastectomy with pure DCIS.

It's really interesting and helpful to hear everyones input, so thank you!!