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Gynecology (Expert Forum)
ablation vs hysterectomy & tamoxifen
Answered by
Keith Downing, MD - Obstetrics, Gynecology
MA
This forum is for questions and support regarding gynecology issues such as: Cervical Disorders, Colposcopy, Cramps, Cystitis, Fallopian Tube Disorders, Menstruation, Ovarian Disorders, PAP Test, Pelvic Exam, PID, PMS, Surgery, Tests, Ultrasound, Uterine Disorders, Vaginal Disorders.
ablation vs hysterectomy & tamoxifen
by txgrl01, Jan 29, 2008 11:55AM
Perimenopausal breast cancer survivor on tamoxifen. After 4 months, diagnosed with AUB due to simple hyperplasia and polyps. Given a choice of hysterectomy or Ablation. Can't find any literature regarding ablation followup care since tamoxifen would be continued for 2-3 more years. What is the risk of endometrial carcinoma or other gyn issues after ablation since tamoxifen would still be providing an estrongenic effect?
Doctor's Answer
by Keith Downing, MD, Feb 03, 2008 10:34AM
, Feb 03, 2008 10:34AM
Hello,
The problem with ablation is that it does not alter your risk of endometrial cancer and could possibly lead to an occult cancer that does not result in bleeding (bleeding typically being the first sign of endometrial cancer that allows for early intervention). Hysterectomy would eliminate this risk.
There is very little literature regarding ablation and Tamoxifen. The studies that have been conducted have had few patients and only short term follow up.
So, if you underwent an ablation you would be entering unknown territory in terms of your cancer risk and deciding how best to follow you knowing you may not present with bleeding, and blind biopsies may not be as accurate.
Best regards,
Dr. Downing
The problem with ablation is that it does not alter your risk of endometrial cancer and could possibly lead to an occult cancer that does not result in bleeding (bleeding typically being the first sign of endometrial cancer that allows for early intervention). Hysterectomy would eliminate this risk.
There is very little literature regarding ablation and Tamoxifen. The studies that have been conducted have had few patients and only short term follow up.
So, if you underwent an ablation you would be entering unknown territory in terms of your cancer risk and deciding how best to follow you knowing you may not present with bleeding, and blind biopsies may not be as accurate.
Best regards,
Dr. Downing
