BREAST CANCER COMMUNITY
Why should I take Tamoxifen

Why should I take Tamoxifen

Approx 2 yrs. ago, I had non-invasive ductal cell carcinoma in situ. I under went lumpectomy and radiation. I was placed on tamoxifen, which I have taken for 2 yrs.  However, 11 years ago, I underwent a complete hysterectomy and had been on HRT which I immediately discontinued at the time of diagnosis of breast cancer.  My question is , if I am incapable of producing ovarian estrogen and I do not take any form of HRT  is it necessary to continue to take tamoxifen? Have there been studies of women who had estrogen positive breast cancer while on HRT due to hysterectomy and stopped their source of estrogen. The only information that I can find talks the women who had ovaries, and I have not found any information that talks about the women who have had hysterectomies prior to breast cancer.
Two years into five year tamoxifen stretch and I am very uncomfortable with night sweats, hot flashes, and mood swings, I understand  there are antidepressants that help side effects but am really considering stopping the tamoxifen altogether because I have no  estrogen to fight off.  
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Even though you have had a hysterectomy, one of the three types of estrogen, Estrone, is still produced by body tissues, especially fat and muscle.  The tamoxifen also blocks this type of estrogen from fueling the growth of cancer cells.

I think that you should talk with your doctor about your side effects and see what can be done to mitigate them.  Evaluate your treatment plan and side effects and whether aromatase inhibitors might be a treatment option.  Antidepressants or other measures may provide relief, while not compromising your treatment.

Thinking of you (and sharing the night sweats.)
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In your discussion with your doctor you might also ask her/him to explain the risk calculation. That is, what is your risk of recurrence by taking the hormone-suppressors and NOT taking the hormone-suppressors. It is different for each woman. There is a formula to calculate it based on stage of disease, type of tumor, age at diagnosis and other factors. There's a computer program that doctors have access to that when you input the right data will automatically calculate the recurrence risk for the individual patient.

In my case, the risk of recurrence was reduced by only 3% - so it wasn't enough for me to suffer the side effects. Each woman is different, though. Other women obtain a very high risk reduction rate by taking hormone-suppressors - or have a lower tolerance for risk in general and see even a 3% reduction as valuable enough to endure the significant side effects.

There is a lot of pressure to take hormone-suppressors and many articles around - a lot of it written by so called experts and placed through publicity channels in the mainstream media. These "experts" are being paid in some way or other by the drug companies to spread this message around to help increase use of their highly profitable pharmaceutical products. They get to sell the hormone-suppressors AND the drugs to help mitigate the side effects it's a win/win for them. Breast cancer treatment is a highly profitable business and a lot of different factions want in on the action.

Understanding your real risk of recurrence and how it may be effected by these drugs will help you make the right decision for you.
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