uterine fibroids in menopause

Carla-Faith · March 2018

Hi Everyone: I am so glad to have found this community. Let me give some background. I am a 10 year breast cancer survivor. I had a stage II A with a 2 cm tumor with 3 lymph nodes involved. I have been on tamoxifen for 10 years. My oncologist is releasing me as of last week. However, he did one final CA 27-29 test that was slightly elevated to 50. I am usually anywhere between 35 and 45 over the last ten years. It bounces back and forth. I know there are benign things that can make it elevated. One being uterine problems. Well after seeing my gynecologist this past Friday, she says I have 2 fibroids, one fairly large. She says she doesn't think it is anything malignant. bit O needed a hysterectomy. But, also said she needed to let me know that tamoxifen raises my chance of having a uterine sarcoma. She said sometimes things look like a fibroid and it turns out to be cancer. Has anyone had a fibroid grow in menopause and it be benign? I am so TERRIFIED!!!! Someone please give me some reassurance.

Carla-Faith · March 2018

No-one has responded. Does that mean it is probably something bad?

ShetlandPony · March 2018

Carla, I decided to reach out so you won't feel alone while you are waiting for responses. It has been less than an hour since your post. I think you will get responses as more people have a chance to log on and read.

Since tamoxifen is hyper-estrogenic on the uterus, it makes sense to me that it could promote the growth of fibroids. And now that you are off it, the fibroids might shrink. Can your doctor recommend a way to test for uterine cancer that is less extreme than a hysterectomy? If not for the small tamoxifen-related risk, would the doc still be recommending surgery because of fibroids that are not bothering you? I think it is wise to get a second opinion whenever surgery is in question.

As far as the tumor marker, is the doc willing to order a scan for your peace of mind?

ksusan · March 2018

I don't know what ":bit O needed a hysterectomy." means. Maybe you could clarify?

The risk of endometrial cancer from Tamoxifen is 0-2% depending on the study or clinical report.I'm pretty sure "Uterine sarcoma" is not caused by Tamoxifen and isn't the same thing as "endometrial cancer."

Tamoxifen can promote fibroid growth. Fibroids generally look like fibroids on imaging, or so I understand from my ultrasound-related conversations.

You may need an opinion from a different doc.

Carla-Faith · March 2018

"Bit O" was a mistake. It should have said "But I". Sorry about that. I do appreciate the response as I was unsure if tamoxifen could make a fibroid grow if in menopause. However, since it acts as an estrogen in the uterus and fibroids need estrogen, it would make sense. I am just scared of the uterine sarcoma. She said it was rare, but the chances increase because of tamoxifen and because the fibroids have grown recently. I am just a basket case about this. I just found out I am going to be a grandmother and sure want to be around for a while and I read that that particular cancer is aggressive and hard to diagnose. This never gets easier. I will be very nervous until I get the results, but am actually afraid to hear them say the words, It's cancer.

ksusan · March 2018

Tamoxifen doesn't cause uterine sarcoma as far as I know. It has a low chance of causing endometrial cancer. The population rate of endometrial cancer is 1%. The rate for people taking Tamoxifen is either the same or 2%, depending on the study. Always worth checking medical questions, but what you describe sounds like fibroids and perhaps a fear that your endometrium MIGHT be sensitive to Tamoxifen.

uterine fibroids in menopause

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