Surgical vs medical menopause

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  • Variable
    Variable Member Posts: 77
    edited February 2017

    I was never offered anything other than discontinuing my birth control and taking Tomoxifen to address my ER+ status. I have been unable to choke down the pill for some unknown compelling reason (supposed to have started that in December :/), and am now in the process of planning a hysterectomy for issues related to fibroids and a thick uterine lining before I can even start Tomoxifen. I have to be put out for a uterine biopsy before the actual hysterectomy can be scheduled. Gyno is recommending the total hysterectomy due to BC diagnosis and ER+ status. I believe my MO is brilliant, but should he have given me some other medical options for treatment here?

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  • Falconer
    Falconer Member Posts: 1,192
    edited February 2017

    Variable- It's good to know that you feel confident in your MOs qualifications. FYI here is one of the publications that has impacted recent thinking in oncology.

    Absolute Benefit of Adjuvant Endocrine Therapies for Premenopausal Women With Hormone Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative Early Breast Cancer: TEXT and SOFT Trials

    http://ascopubs.org/doi/full/10.1200/JCO.2015.64.3...

    Best to you as you navigate through

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  • Variable
    Variable Member Posts: 77
    edited February 2017

    Thanks Falconer! My brain is slow to interpret the study, but it looks like a 3% benefit with ovarian suppressor for those in the SOFT group?

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  • Falconer
    Falconer Member Posts: 1,192
    edited February 2017

    Well I'm not a numbers person myself- I'm an English teacher- but in another related article the authors concluded the following:

    Absolute Benefit of Adjuvant Endocrine Therapies for Premenopausal Women With Hormone Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative Early Breast Cancer: TEXT and SOFT Trials

    "extended adjuvant therapy with letrozole after 5 years of tamoxifen suggested that women who were premenopausal at the time of tamoxifen initiation but became postmenopausal by the end of tamoxifen treatment were especially likely to benefit from extended letrozole. It will thus continue to be a challenge in practice to choose between tamoxifen monotherapy for 10 years, tamoxifen for 5 years followed by an aromatase inhibitor for the patient who becomes naturally menopausal during tamoxifen treatment, or 5 years of aromatase inhibitor plus OFS for premeno- pausal patients, even if the SOFT trial shows benefit of 5 years of tamoxifen plus OFS compared with 5 years of tamoxifen alone."

    Your MO knows all of this, but when you speak with him, it'll be good that you're informed. Hope this helps.

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  • Variable
    Variable Member Posts: 77
    edited February 2017

    Thanks again Falconer!

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  • JMouse
    JMouse Member Posts: 78
    edited May 2019

    Lovey222, knowing what I know now, I too would have requested hormone suppression at my initial Dx and surgery. For us with hormone positive BC, I wonder why it's not offered...?

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