Tamoxifen is a carcinogen??!

Tamoxifen can cause cancer, although the chances of that happening are quite low. For many women, the likelihood of their breast cancer coming back without tamoxifen is far greater than the likelihood of developing a new primary cancer due to tamoxifen.

For me it was a no-brainer: 30% recurrence risk of breast cancer without tamoxifen, or a less than 1% chance of uterine cancer on tamoxifen. Also, many women who remove their ovaries still need to be on hormone meds to block the effects of estrogen in the body. Your brain makes estrogen too.

As for fighting cancer with cancer, yes, it's not ideal, but it's the best we have right now. Maybe one day there will be a better cure. It all depends of your individual statistics whether or not tamoxifen is worth it. I can understand your misgivings - before cancer I was always a natural sort of person, and I didn't even like taking ibuprofen, but here I am. Best wishes to you in your decision.

Fair question, Briannadawn.

I do wonder why DCIS is treated with surgery, radiation and Tamoxifen in the same way that higher stage cancers are. It does seem like overkill...? My breast surgeon recommended this course of action during my first consult with her. I'm going to reserve any decisions until I have all the information back from the pathology report and have an appointment with the MO to see what she says is my own personal risk. For what it's worth, I'm 48 and plan on hanging around at least another 30 years so that will always be in my decision making.

DCIS can progress and develop into a worse prognosis, which, of course, we would not want to happen.

Tamoxifen continues to lower your risk years after you stop taking it.

People with invasive breast cancer are at risk of distant (metastatic) recurrence and mortality from their current invasive breast cancer diagnosis (the size of these risks depends on details of diagnosis), and reducing these particular risks is typically the primary purpose of endocrine therapy (e.g., Tamoxifen, an aromatase inhibitor) when recommended in such patients. (They can also reap benefits in loco-regional control.)

In contrast, the primary purpose of endocrine therapy (e.g., Tamoxifen, an aromatase inhibitor) in those with pure DCIS (non-invasive, Stage 0) disease is to reduce the risks of same in-breast local recurrence or new disease, and secondarily, the risk of new disease in the contralateral breast. In general, although the incidence of severe adverse effects of Tamoxifen (i.e., certain uterine malignancies, stroke and pulmonary embolism) is very low, given the distinctly different nature of the risks driving treatment recommendations for DCIS, those risks tend to weigh heavier against the potential benefit.

The situation of a person with some type of Stage III invasive breast cancer (which carries significant risks of distant recurrence and breast cancer mortality) is quite different from that of a person with pure DCIS (Stage 0, a "non-invasive" condition). The main commonality is the need for a personalized risk/benefit analysis.

BarredOwl

Brianna:

If you had the additional recommended lymph node surgery and mastectomy after you were told "Stage 3", there would be another pathology report from that additional surgery.

"Stage 3" could include any one of three different stages with differing prognoses and treatment recommendations:

Stage IIIA, Stage IIIB or Stage IIIC.

Supplements are extensively discussed in the Alternative Forum and Complementary Forum. If you want to learn about supplements, feel free to visit those Forums.

You posted here in a Conventional thread and you asked questions about oophorectomy and Tamoxifen. Naturally, people answered those questions.

If a person with "Stage 3" breast cancer says they are "confused" about Tamoxifen use in light of certain relatively rare severe adverse side effects, people are going to explain how the benefits of treatment are weighed against the risks of treatment.

If a person later asks whether there is any benefit after Tamoxifen treatment stops, people may comment on that. (By the way, I only know that "trailing benefit" has been seen for "early stage breast cancer." However, "Stage 3" includes several different stages, some of which are not "early breast cancer" and I know nothing about them.)

If person asks about removing their ovaries, people will comment on that. Of course, bilateral oophorectomy is not without risks of its own (it is not risk-free). Please discuss it with your team.

As noted by others above, bilateral oophorectomy does not obviate the need for endocrine therapy when indicated under clinical guidelines. If a person has a bilateral oophorectomy, they are considered "post-menopausal." If a person with some type of Stage 3 breast cancer receives a bilateral oophorectomy, a Medical Oncologist would likely still recommend an Aromatase Inhibitor (or Tamoxifen), because clinically significant amounts of estrogen are still produced by tissues other than the ovary in post-menopausal women. That said, AI's have a very different side effect profile from Tamoxifen, and so some prefer an AI to Tamoxifen because of that.

For completeness only, I note that instead of bilateral oophorectomy plus endocrine therapy, appropriate patients may choose the option of an ovarian suppression drug plus Tamoxifen or an AI. Some try this approach before transitioning to permanent oophorectomy plus Tamoxifen or an AI.

Again, information about supplements used by members here can be found in other Forums, although to my layperson's knowledge, unlike Tamoxifen and AI's, supplements are not supported by clinical evidence of therapeutic efficacy in terms of statistically significant improvements in distant disease-free survival and in overall survival from trials in patients with hormone receptor-positive invasive breast cancer.

BarredOwl

Breathing is a carcinogen.

By opening our mouths and taking in air, we also take in whatever particles are in the air, and inevitably, some of those particles are cancer-causing.

So we can choose not to breathe. The problem however is that the risk of death from not breathing is much higher and more certain, and much more imminent, than the risk that some of those carcinogens that we've inhaled might actually one day turn into cancer, and that this cancer might become deadly.

Briannadawn, if your diagnosis is what's been discussed here, a very large tumor with extensive nodal involvement, my example, while silly, isn't that far off from the reality of your situation, with regard to your risk from your current disease vs. the potential long-term risk from conventional treatments such as chemo and Tamoxifen

Never mind Big Pharma, Cancer is Evil. However bad you think Big Pharma is, compared to Cancer, it's a bunny rabbit.