Freaking out- please help!!

[bc1739]

I am 42 yrs old.  I was diagnosed w/breast cancer at 39.  I had a bi lateral mastectomy and did CMR chemo.  I am currently on tamoxifen.   I recently had a tvu and they found a 5 cm cyst on my ovaries.  I did not think much of it since my Gyn never followed up w/me.  Also, I tested negative for BRCA-1.
I have had light cramping since sunday and light back pain- also sometimes nausea.   I do not have weight gain or weight loss and my clothes fit the same.  
I just went for CA 125 blood test this morning.  Should I be worried ?   Could this be ovarian cancer?   There is no family history

[Annekathryn Goodman, M.D.]

Hi There,

At 42 , a simple 5 cm ovarian cyst is most likely from ovulation.A repeat ultrasound after a period is the next step. However, I do agree with the excellent comments from "hopeshell".  Should you have a persistent cyst, the next step would be a laparoscopy and removal of the cyst and possibly the whole ovary.  Now the tricky question is whether you should have the prophylactic removal of both your ovaries and fallopian tubes.  Without a family history of ovarian cancer or a BRCA mutation, you do not have the "high risk" label for ovarian cancer.However, I worry that a woman who develops breast cancer at such an early age, may have a higher risk for ovarian cancer.

But removing both ovaries would put you into menopause. With your breast cancer history, estrogen replacement therapy is not given.  Surgical menopause can be tough.

I guess I would temporize and see what your follow up ultrasound shows and go from there. But ask your doctor about these other issues or meet with a gyn oncologist for consultation.
best wishes

[hopeshell]

Oops, guess I posted in the wrong forum.   Sorry!!! :)

[hopeshell]

Hi there,
I think the standard for removal of an ovarian cyst is 5cm or above.  That said, considering your history, I would make sure to see an gynecologic oncologist and get the cyst removed.  The earlier ovca is removed the better.  It could also be a number of other things.  But, you should follow-up right away with a gyn/onc.  I am sorry to hear the angst in your post because I know how you feel and it stinks!  Just so you know, I was dx two years ago and there was not a family history.  As you know from being a cancer survivor already, you just have to get it checked out right away.   I will be praying or a good outcome for you.  Keep us posted!