Ooph vs hysterectomy
A little background info: I’m 35yo diagnosed IDC 2 months ago, and am 1/3rd of the way through neoadj TAC chemo. Genetic testing came back CHEK2+
Once I’m done with chemo (mid Jan), I’ll have BMX. A few weeks after that surgery, my gyne oncologist is recommending either an ooph or hysterectomy. I’m done having kids. Are there risks/benefits of doing one vs the other? Right now I’m leaning toward hysterectomy since I don’t want to have to worry about uterine cancer while on tamoxifen. Also, I figure what’s the purpose of keeping the uterus if I’m getting rid of the ovaries and Fallopian tubes anyway? Early menopause scares me a little, soI appreciate any input!
Comments
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I'm not sure how the CHEK2+ influences the uterus or the ovaries. Are you at increased risk for cancers of those organs due to the mutation?
Having your ovaries removed will put you in menopause and greatly reduce the risk for ovarian cancer. With ER+ cancer, it will also reduce the Estrogen circulating in your body. You would be able to take Tamoxifen or an AI to further reduce the recurrence risk.
Having your uterus removed will not alter your hormonal status. It would remove the small risk of uterine cancer due to Tamoxifen. However - the uterus is helpful for support of your bladder and other internal structures. And remaining premenopausal may mean that you will require suppression of the ovaries.
Do you see a MO or just the GYN onc?
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CHEK2 increases risk for other cancers, ovarian being one. Not much is known about about the mutation yet, but enough that my MO and GYN Onc both suggest ooph at the very least. I guess what I'd like opinions on is if the hysterectomy is really worth it, or if there's a huge difference in just getting ovaries removed vs ovaries and uterus. Are there compelling reasons to keep the uterus? Good to know that the uterus supports other internal organs.
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I have a PALB2 mutation which has been getting more and more research to prove that it definitely means you have an much higher chance of getting BC (I'm only 46) and a lower (aka unknown) risk of pancreatic and ovarian cancer. I'm meeting with the gynecologist scheduled to do my surgery in early December to discuss my diagnosis. Originally, I was thinking of just having my ovaries removed because even though I became menopausal 2 months after starting chemo, I won't be "officially" menopausal until 5 years no period, and I'm on anastrozole, which is for women who are post-menopausal because my MO thinks it is a better medication for my situation. If I didn't have my ovaries out, my MO wanted to give me shots to make sure my ovaries don't produce Estrogen, so I decided to simply have them out to avoid more medication and the looming threat of ovarian cancer. When I met with the gynecologist to begin my preliminary discussion about surgery, I thought that my mother had had uterine cancer, so the doc recommended a hysterectomy as well because there is a lot of tissue down there and taking out more is better. I've recently learned that she did not have cancer and so I'm going to go back and discuss whether or not it still makes sense to have a hysterectomy. #1 reason is that there can be some pretty bad side effects with bladder leaking and pain during intercourse, so I'm not 100% sure if it is really worth the risk. I'm happy to share what I learn from my pre-op meeting with my GYN in Dec.
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Thank you Melissa. That’d be great!!
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