Prophylactic oophorectomy or not in younger ladies?
Hi, I am 36, stage 3A breast cancer patient, with 8 nodes involved. I have completed bilateral mastectomy, chemo (4AC,4 taxotere) and radiotherapy. My genetic test is pending. I was wondering if I should go for prophylactic oophorectomy but my oncologist thinks its risks outweigh it's benefit. Anyone had done this prophylactic surgery? Was it suggested by your oncologist or gynaecologist? I am really struggling with a decision. Thanks!
Comments
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Hi MangoGirl, and welcome to Breastcancer.org!
We're so sorry for the reasons that bring you here, but we're really glad you've found us. You're sure to find our Community an incredible source of information, advice, and support -- we're all here for you!
While you wait for some responses from our ever-helpful members, we wanted to share with you this page from the main Breastcancer.org site on Is Prophylactic Ovary Removal Right for You? which offers some good points to consider.
We hope this helps. Please let us know what you decide and keep us posted on how you're doing!
--The Mods
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I had prophy oophorectomy but when I had it, I was 50 (diagnosed at 49). I was peri-menopausal prior to diagnosis, but oophorectomy threw me into full blown menopause. I had the surgery based on recommendation of my oncologist at time of Dx. I can't say what I would have done if I had been diagnosed in my 30s but if you were my daughter I would say follow your oncologist's suggestion, but if you are not comfortable, then get a second opinion. You can always have the surgery down the road if you are not ready at this time. But that said, listen to your gut feeling/listen to your heart. All the best to you.
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Thank you Moderators and karen1956. This site does have very useful information!
I have asked 3 Oncologists which all say no to oophorectomy at this stage. A gynaecologist and my gut feeling says go for it. But I am still feeling exhausted from the treatments. I guess I will delay it first for now and probably think about it again later.. thanks again
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hi mango girl, i’m 39, was diagnosed in february of this year. i had the same dilemma but opted to push through with total hysterectomy with bilateral salpingo oophorectomy via laparoscopy, which was done last week. So far, i feel the same. i went thru hot flashes during chemo, i didn’t have any after the procedure. My oncologist didn’t think it was necessary since they can do clinical menopause, i decided out of convenience and wanting to start on Femara. i didn’t want to keep going back to the hospital for shots and i’m quite happy with the size of my family, i have 4 kids .
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Thanks for sharing your experience. You are a strong lady. Same like you, I had hot flushes at the start of chemo as was also started on Lucrein then. I guess I will consider the surgery again later next year. I hope you are recovering well from the surgery and will tolerate Femara well! Take care!
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Hi Mangogirl, I was 34 when diagnosed and ultimately my oncologist recommended I do 3 years of ovarian suppression instead of an oopherectomy. There was not a consensus though among my team of doctors about what was best, it was split between do nothing, oopherectomy and ovarian suppression. Some factors that tipped the scales in favor of just doing the ovarian suppression were a personal history of a tendency towards osteoporosis and a strong family history of heart disease (2 things that are affected by hormone levels). I did 3 years of Lupron injections. The hot flashes were insane and I had some hair thinning but overall it wasn't bad. I finished the Lupron 2 years ago, and it took about 6 months before my cycles came back after stopping. I still have hot flashes but they are very mild and not frequent.
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Thanks kcat2013 for your sharing. Good to hear from ladies with similar experience. Did your oncologist monitor your hormone level while you were on Lupron? Were you on Tamoxifen or Aromatase inhibitors when on Lupron?
My estradiol level is 170, slightly higher after I was started on Tamoxifen (estradiol level 140). Hence, it makes me slightly uneasy if my estradiol level is sufficiently suppressed with Lucrein.
Thanks again for sharing!
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Mangogirl, since tamoxifen prevents estrogen from binding to receptors it would make sense that circulating estrogen would be higher. It isn’t getting “sucked up” by the receptors
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If you want to, you could talk to your MOs about ovarian suppression drugs with your hormone medications. That way you can try out being post-menopausal, but it's reversible.
Just my opinion, but I'd be very careful about choosing irreversible menopause at our age. There are too many quality of life impacts... cognitive function, cardiac health, bone health, fertility, sexual function, urinary function... You can always do the surgery later, but once it's done there's no going back.
If your genetic testing shows something, that's another story though. It's a hard situation for us younger ladies no matter what. Best wishes to you.
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MangoGirl, my doctor did not monitor my hormone levels while on the Lupron. And I took Tamoxifen in conjunction with the Lupron.
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MelissaDall - Your explanation makes sense! Thank you very much!
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kcat2013 - Thank you for sharing your experience. I am also on Tamoxifen and Lucrein now. Take care!
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buttonsmach - Thanks for your input. You mentioned my exact dilemma. I am on Lucrein - the monthly jab to suppress my estrogen. Will likely consider oophorectomy much later. Thanks again.
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