Affects of Tamoxofin

I am 10 months post radiation for Stage 1-2 breast cancer and have been on Tamoxofin for 10 months.   I am 53 y/o and still premenopausal although I did stop my period 7 months ago but six months ago starting bleeding continuously but very lightly.   I had a cervical bx for a polyp which ended up being endometrial and a D&C which apparently was unsuccessful.    After 1 1/2 hours my doctor was unable to remove all the polyps in the uterus.     I am now scheduled for a hysterectomy.   My GYN doctor is wanting to do a vaginal hysterectomy removing the uterus, ovaries, and cervix.     My surgeon for the breast cancer does not think I should have the ovaries and cervix removed.    My GYN doctor wants me off of the Tamoxofin and wants me on something else like Evista.       Can I get your opinion?

[PaulMD]

Hi there.

At the present, the role of Evista in breast cancer is still not fully defined.  It has been shown to lower the incidence of invasive breast cancer among those who are at high risk.  But for someone who is already diagnosed with breast cancer, the role of Evista is still not clearly defined.  Tamoxifen can increase the risk of developing a uterine malignancy and I believe it is the right decision to have the uterus removed.  The ovaries are also likely to lose function in the next few months or years, brought about by natural menopause so I understand why there is a hesitance to remove this.  However, removing the ovaries can make you eligible to receive aromatase inhibitors (like arimidex or femara) which carries a more favorable side effect profile compared to tamoxifen.