Ovarian removal benefits and risks

[SusanHSC]

I'm BRCA negative, with stage II cancer diagnosed December 2002.  I've had mastectomy, chemo, and radiation, and am now doing reconstruction.  I'm on tamoxifen, as I'm 40 and mostly pre-menopausal.  

With my next round of surgery, I can have my ovaries removed.  I don't know whether to do this or not.  Are there benefits beyond being able to take Arimidex instead of Tamoxifen?  I want to do absolutely everything I can to get even a small benefit.

What are the down sides?  Do ovaries provide any function beyond the estrogen that I'd lose if I had them out? (Of course, I know that means no more children, but I've already accepted that.)

Thank you.

[kr16]

A related discussion, oophorectomy was started.

[dammie]

I too, am a BRCA neg with stage 2 with lymph node involvement.  I had a double mastectomy and just had implants inserted a month ago after expansion.  I had the bilateral oopherectomy at the same time due to  the advise of my oncologist due to a strong family history.  If you doctor advises it, it is not a difficult surgery but you do go into menopause. Any benefit is worth it. Just to note,  I was told  that tha risk of osteoporosis increases so I have to supplement with calcium and have bone density tests for monitoring.  Good luck

[CCF-RN,MSN-rf]

Dear SusanHSC:  There has been some question as to what role ovarian ablation (drying up the ovaries) has in the treatment of early stage breast cancers. This treatment has shown benefit in the treatment of metastatic breast cancer, so they are now studying it in terms of adjuvant treatment for early cancers. The reason for doing it would be to further decrease the estrogen available to estrogen-receptive tumors.

Ovarian ablation is used far less frequently in the United States. Methods to accomplish ablation are surgical (oopherectomy), radiation therapy to the ovaries, or chemical suppression of ovarian function. Ovarian ablation appears to produce a similar benefit to some chemotherapy regimens. Combining ovarian ablation with chemotherapy has not been shown to provide an additional advantage to date. The value of combining hormonal therapies has not yet been adequately explored.

Side effects to ablation are those experienced with natural menopause. In your search for additional reading material regarding ovarian ablation you could look in terms of the different methods. Oopherectomy (removal of the ovaries) is the name of the surgical procedure. Some names of common medications used to produce ablation are goserelin (also known as Zoladex), or leuprolide (Lupron).

Aside from the benefits of estrogen and your short term physical well being, the ovaries do not provide much more if they were to be removed.