Oopherectomy vs Hysterectomy
A little about me...diagnosed about 11 months ago at age 46 premenopausal. Er/Pr +, Her 2 -, 1 positive sentinel node. My genetic testing was negative. My grandmother had breast cancer twice, 1 x in each breast. No known family hx of ovarian or uterine cancer. I completed chemo and rads and started Tamoxifen the 1 st of Jan 2018. My MO and I were in agreement that I would do ovarian suppression and switch to an AI this summer. We were both leaning towards an oopherectomy vs Lupton shots but I said I wanted a consult with my Gynecologist. My gyn came back and said he recommends a complete hysterectomy because of the family hx. Not sure why hysterectomy scares me more so than a oopherectomy. I think mainly because more surgery and recovery time. I am very torn...I want to do everything to prevent recurrence. Had anyone been in a similar situation and what have you chosen. I have spoken to my MO and he understands why my gyn made his recommendation but still says he is comfortable with decision of only oopherectomy at this time. Also should add I have no last hx of cysts, difficult periods, etc.
Comments
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They are finding that some ovarian cancer starts in the tubes so many women treat that as a priority. Some of the tube does go into the uterus but it is considered a lesser risk. It's worth taking into account though.
I could not handle AI and am back on tamoxifen . So you might want to try Lupron first and see what it's like. Research bone ans muscle loss because I was not told about this.
It also is worth reading a bit more on the SOFT and TEXTA studies. An update I read was that shutting sown the ovaries doesn't improve survival in some women but does increase side effects and symptoms of menopause far more than tamoxifen alone.
I can attest to that. If I could have avoided it I would have but there is a strong history of both uterine cancer and ovarian in my family.
If you have either procedure I strongly recomend the da vincie (think that is the name) or orthoscopic OO or hysterectomy. Open abdomenal was not a fun recovery.
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Runnermum - I had a hyster spalingo and ooph in Oct of last year. I had to decide if I wanted my ovaries out. The uterus cervix tubes were coming out anyway. I had a robotic hyster and the recovery time is greater vs just an ooph but it was very easy, but lifting restrictions that last about 6 weeks. I was very scared initially going through it, but it was actually very easy to recover...and I was sent home the same day....
My sister had uterine cancer. I did genetic testing and tested negative for 34 cancer causing genes...HOWEVER, my family tree is full of cancer...but no other breast cancer. We had early age cancers (cousin and sister- both in their 30's) in our family, and my breast cancer was bilateral, which is indicative of a hereditary cancer. BUT there just isn't any gene to connect it to in my family tree, or as it was expressed to me "most likely the gene impacting your family has not been discovered YET." I just decided get everything out that could be a potential problem. Research does support that ovarian cancer is thought to start in the tubes, so my docs strongly recommended to take them out. With hormone therapy I think you have to assess the risks with Tamoxifen or the AI, and then with suppressing the ovaries or going through the side effects of losing estrogen, which can have impacts on your bones, etc. I was 47 when I went into surgical menopause and now 48yo....I had hot flashes that began at 4wks after surgery, joint pain, etc....can you get a second opinion from another onc and gyno?
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I did ooph/salpingectomy/hysterectomy including cervix in Nov last year. It was done using lap-vag technique. I had it done at the same time as my phase 2 reconstruction. I honestly asked them over and over if they were sure they did the procedure because I felt absolutely no pain/discomfort whatsoever afterward. Only pain I had was in the areas they operated on for the recon. Lifting restrictions were in place for 4 weeks for the hyst. I dont think Ive ever had an easier surgery (and I've had plenty). I thought my hips and/or legs would at least be sore from being in the stirrups so long during surgery but not even any twinges of discomfort in that respect either.
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