Removing ovaries to prevent breast cancer

[Eileen550]

I had stage 1 estrogen receptive breast cancer 5 years ago at age 44.  I had 9 lymph nodes removed with minor amount (if that's possible) found in one.  I had 6 mos chemo and 7 weeks radiation. I took Tamoxifin (tamoxifen) for 2 years and couldn't bear it.  I was and continue to be premenopausal. I am not genetically predisposed to breast or ovarian cancer.  I have to have a hysterectomy due to fibroid tumors.  My gynocolgist is recommending removing my ovaries too.  I can't find any literature linking a significant reduction in reoccurrence of breast cancer and removal of the ovaries in women who do not have the genetic marker.  Do you?  I don't want to have my ovaries removed without more information that speaks to my situation.

[riley180]

Yes, before the use of Tamoxifen removal of the ovary has been used as a means of hormone therapy.  The best time to have them removed would be  around the time of the initial breast surgery. If it is now 5 years after your surgery and you are nearing menopause, the benefit of  removing your ovaries to prevent breast cancer is questionable. Tamoxifen likewise, is usually given for 2 years only. You could explore the possibility of using an Aromatase Inhibitor, as some patients after 5 years on Tamoxifen, who  take an Aromatase inhibitor, seem to get additional protection. The effect of the aromatase Inhibitor is likely to surpass the benefit of removing   the ovaries if you are post-menopausal  (and it only works in this patient group).

[often]

I think you need to have a conversation with the gyn.  How active are your ovaries at this time.  At your age, mine were pretty much done with providing me any benefits, but yours may still be providing the estrogen.  Surgical menopause is never easy, because it is so sudden.  You might also want to discuss with your oncologist whether he/she feels this would be beneficial to you as far as recurrence. Once you have all the info, then make your decision.  As riley180 mentioned, there is the possibility of trying the aromatase inhibitor, but if you could not take the Tamoxifen, it is highly likely that Arimidex would create the same difficulties for you.  In either case, make sure that your gyn puts you on one of the meds to help prevent osteoporosis...loss of estrogen will cause loss of bone density...and the aromatase inhibitors will aggravate that.