Two questions - Surgical and medicine

I am 49 a single mom with three kids, one is special needs. I have been diagnosed with high grade DCIS and LCIS. I also have MS.

First does anyone know if it is possible to have double mastectomy, reconstruction and hysterectomy at the same time? I'm in good shape, well other the above mentioned of course.

Second if I did all this would I still be put on the anti-estrogen drugs. Yes I'm post menopause so it would be the ones that totally block estrogen like Femara not Tamoxifen. After all that I'd hate to then worry about hypertension and osteoporosis.
Thanks for you help.

[bluebutterfly2222]

Hi again,

I'm not sure of the wisdom of such a plan, or how realistic it would be, due to the logistics involved in arranging the different surgeons, etc., needed for those surgical procedures.

I'm also not sure why you are considering a hysterectomy, unless you have GYN issues? Some women decide to have oopherectomy if there is a  family hx of ovarian cancer or they  are at high risk as determined by genetic testing.

When  this is not the case, however, a  recent study that  has raised question about the benefit of that step. Statistical analysis showed that during the 25 years of follow-up, women who  had removal of normal ovaries had a higher all-cause mortality rate, mainly from coronary heart disease and lung cancer. Although there was a lower incidence of breast cancer, ovarian cancer, and in fact all cancers in the women who had their ovaries removed, the risk of death from cancer was higher.

At no stage of the study was survival higher for the women whose ovaries were removed.
The increase in cardiovascular risk and mortality has been found in other studies, although none this large. For women who are not at increased risk of ovarian cancer, prophylactic ovary removal may not be beneficial, and needs to be reconsidered. Source: OBSTETRICS & GYNECOLOGY (113: 1027, '09)

Moreover, you would probably still be advised take an estrogen-blocking drug, because estogen is produced in other parts of the body, not just the ovaries.

I would suggest that you discuss in detail, with all your physicians, the plan you mentioned, so that all relevant aspects of your family and personal health histories would be taken into consideration

Best wishes...

[Greysean]

Thank you that helps a lot and of course I'll be doing a lot of talking with all doctors involved. For my gyn. I see a Dr. who was a reproductive endocrinologist who now specializes in menopause. I went to him when I couldn't tell the difference between some of the M.S. symptoms and some of the menopause symptoms. He does not like the estrogen blocking drugs - he made that clear but at the same time knows it may be the protocol I will be put on. That said he is the one who thought a hysterectomy was in my future and if so I just wondered it that was too much to do all at once.  
From the surgeon I talked to having the added LCIS he did say that made it a higer chance for reoccurence and for ovarian cancer. I am hoping to also talk to an oncologist before making final decisions. He said in cases such as mine usually the oncologist isn't brought on board till after the surgery but since they give statics and such I think I will want to hear what he has to say. Thank you again, any information I can get helps greatly.
I'm just assuming but I've seen a lot of your replies, I'm gathering you are a survivor and not going through treatments now. How are you doing?

[katarina777]

I was  laughing reading your question, reminded of all the things I thoughts, or assumed, or didn't know less than three years ago?

No, I am certain they would not do the three surgeries together.

I assumed the surgeon who did the mastectomy would then take half of my healthy breast and make a new 'other' breast out of it to replace the absent one.