DCIS, ER/PR+, 2 gene mutations, family history ov cx. Oophorectomy soon- no HRT.

DeeseR

So scared about being forced into menopause w/o the benefit of HRT! Also worried about what the lack of estrogen could do to my body… dementia, heart disease, bone loss…

Someone told me not to have the procedure because of these things but, since there is no definitive test for ovarian cancer and I have a family history… how can I possibly take a chance with cancer?!?!?!

LIYAH

Re: Oophorectomy and Your Concerns

Good Afternoon DeeseR,

I understand your anxiety about undergoing an oophorectomy and the potential impact of menopause. It's a significant decision with both benefits and potential risks.

You're right to be concerned about the potential long-term effects of estrogen deficiency, such as an increased risk of osteoporosis, heart disease, and cognitive decline. However, it's crucial to weigh these potential risks against the risk of ovarian cancer.

Given your family history of ovarian cancer and your genetic predisposition (two gene mutations), the risk of developing ovarian cancer is significantly increased. While there's no definitive test for ovarian cancer, your risk assessment likely considered your family history, genetic testing, and other relevant factors.

Here's a breakdown of the situation:

• Benefits of Oophorectomy:
  • Significantly reduces ovarian cancer risk: This is the primary benefit and a crucial consideration given your family history.
  • May reduce the risk of breast cancer recurrence in some cases.
• Potential Risks of Oophorectomy and Estrogen Deficiency:
  • Menopausal symptoms: Hot flashes, night sweats, vaginal dryness, mood swings.
  • Osteoporosis: Increased risk of bone fractures.
  • Cardiovascular disease: Potential increased risk of heart disease.
  • Cognitive decline: Some studies have suggested a possible link between estrogen deficiency and cognitive decline, but more research is needed.

It's crucial to have a thorough discussion with your oncologist.

• Discuss your concerns: Clearly express your fears and anxieties regarding the potential side effects of oophorectomy and menopause.
• Explore all available options: Discuss potential benefits and risks of HRT in detail.
• Consider alternative options: Explore whether there are any alternative treatment options or strategies to mitigate the risks of hormone deficiency.
• Seek a second opinion: If you feel uncertain, consider seeking a second opinion from another qualified oncologist specializing in breast cancer. I always get a second opinion and research the information that the oncologist team provides me.

Remember:

• This is a personal decision. You have the right to make an informed choice about your treatment plan based on your circumstances, values, and risk tolerance.
• Support systems are crucial. Lean on your support network, including family, friends, and support groups, for emotional and practical assistance.
• Consider genetic counseling: A genetic counselor can provide you with detailed information about your genetic risk and help you understand your treatment options.

This is a complex situation, and it's essential to have open and honest discussions with your medical team.

I hope this information is helpful.