should I have my ovaries removed, had breast cancer

I am having surgery on tues. feb 26th to have my ovaries removed.  I had a choice to only have one removed (it has a cyst on it) left side, or I can have both removed.  My doctor feels I should have both because I had breast cancer 1 1\2 yrs ago. Very low grade, slow growing, just entering stage 2.  Didn't need chemo or radiation.  I had double mastectomy, with reconstruction. ( Cancer in right side, same tumor started to grow on the left side. ) I feel after going over this for weeks, that I should have both removed because of my cancer and ovarian cancer is hard to detect. However I am freaking out over how I am going to feel afterwards.  Did any one not have all the side affects or am I doomed. I also take tomaxifen and had very litrtle side affects form it.  A few hot flashes and once in a while cramping in legs.  It took 1 yr to finally enter menopause. I am only into menopause as of this month.  


This discussion is related to ovary removal and tamoxifen or arimidex.

[bluebutterfly2222]

I don't think there is any "right" answer and your physician is in the best position to advise you. If you have a strong family hx of BC and ovarioin cancer or have had genetic testing that shows you have elevated risk, the answer would probably be clear-cut. Otherwise, you might want to also consider the study I am pasting below.

Best wishes....

• REMOVAL OF NORMAL OVARIES  DOES NOT LOWER MORTALITY
It has been common practice for decades to remove normal ovaries when a woman undergoes a
hysterectomy for whatever reason. For women between 40 and 44 years old, 50% have their ovaries
removed with hysterectomy. Of those between 45 and 64 years old, 78% have their ovaries removed. It is
estimated that approximately 300,000 women a year in the United States have what is called a
"prophylactic oopherectomy," which means ovary removal with the intent to prevent later illness. The
primary reason is to prevent ovarian cancer. When the ovaries are removed, a woman goes through an
abrupt "surgical menopause." During natural menopause, hormone production stops more gradually. In
addition, the ovaries continue to make significant amounts of testosterone and androstenedione, which are
converted in the body to estrogen. Later menopause is associated with a lower risk of death from
coronary heart disease and stroke. Studies have shown that preserving the ovaries is associated with a
lower risk of heart disease. To keep it in perspective, ovarian cancer kills 14,700 women in the United States
a year. Coronary heart disease causes the death of 326,900 women a year.

Researchers used data from the Nurses' Health Study group, which included 122,700 women ages 30- 55
in 1976. They have been followed from that time, and entered into this study at the time of hysterectomy.
Data was used if the hysterectomy was not for cancer and the participants reported removal of normal
ovaries. 29,380 women had hysterectomies, and of those, 16,345 had ovaries removed. Researchers looked at
the following events: coronary heart disease, stroke, breast cancer, ovarian cancer, lung cancer, colorectal
cancer, hip fracture, pulmonary embolus, and death due to all causes. A lot of additional data was collected
in order to compare similar groups of women in terms of other factors.

The women were similar in terms of baseline risk factors for cardiovascular disease and cancer, although
the women who had their ovaries removed were slightly older and slightly more likely to be using or have
used hormone therapy. 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 increased 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).