High estrogen level - what did your doctor recommend?
I was diagnosed with DCIS with microinvasion in 2017. Had mastectomy on the affected breast and started taking tamoxifen. Recently, I went to see a gynecologist and she tested my hormone level. My estrogen came back extremely high (she said she's never seen anyone that high before) at 1,046 when normal should be below 300. I haven't ever had my hormone tested before so I don't know if this was caused by tamoxifen or if it has always been high. My gynecologist recommends ovary removal but she said it also carries the risk of heart disease and bone loss so she is not pushing for it strongly either. I asked about Lupron and Zolodex but she said she does not prescribe Lupron for more than 6 months. I asked my onco but he does not seem concerned at all about my high estrogen level. I am worried my high estrogen will cause my breast cancer to come back or cause ovarian cancer but I don't want to remove my ovaries either due to risk of heart disease.
I have a few questions in my mind that I am not clear about:
1) Does tamoxifen increase estrogen level? I know it blocks the effects of estrogen on breast tissue but does it also increase the estrogen level? There is an article in breastcancer.org that seems to suggest that it does. If so, has any of you had experience with your doctor recommending you stop taking it due to high estrogen?
2) How did your doctor decide to prescribe Lupron or Zolodex for you? It seems that hormone level testing is not usually done and I don't know why. Did your onco order the hormone level testing then decided you needed Lupron or Zolodex?
3) What are the pros and cons of Lupron vs. Zolodex?
4) Has anyone had experience with having high estrogen but the your doctor did not recommend Lupron or Zolodex or ovary removal and did not seem concerned about it at all?
Apologize for the long post, but I am confused about whether to ignore my high estrogen which is basically what my onco is suggesting and do nothing about it or push my doctor to at least give me Lupron or Zolodex.
Thank you in advance.
Comments
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I was premenopausal and Tamoxifen raised my estrogen to a high level. I considered having an oophorectomy but all the medical oncologists said I didn't need to. I said to them, if Tamoxifen is not working to block this high estrogen, I am in trouble, right? I was particularly concerned because it was ILC. I wish I had done the ooph. With DCIS, could you use ovarian suppression for a while, a five-year course, and then go back to normal?
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I think it does raise estrogen levels, but blocks receptors which is why it helps us, but can cause side effects from the high estrogen levels. I can't remember where I read that a couple of years ago, but I think it was in a medical text. Tamoxifen was originally made as a fertility drug but then caused birth defects I think.
With that said, if it's true, it's kind of pointless to test levels. Neither my MO nor GYN has ever mentioned testing.
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Tamoxifen is a selective estrogen receptor modulator. . It blocks estrogen receptors in the breast but not in the uterus for example or the bones. It is an estrogen anagonist and stimulates the uterine lining and bone.
https://en.wikipedia.org/wiki/Selective_estrogen_receptor_modulator
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