I am posting here because for some reason I can't start a new thread...........
I have endometriosis and I also have fibrocystic breasts. I had a laparotomy 2 yrs ago to remove a large endometrioma that enveloped my left ovary and was sticking to my colon. Several months after surgery my symptoms started to return so I began taking birth-control pills - progestin only, what they call POP pills.
Within about two months I started having a lot of breast tenderness, which intensified to the point of not being able to walk without having to hold them! Mammo came out ok but a sono revealed 5 lumps - two in the right, three in the left. My insurance co. denied recommendation for an MRI because I have no history of breast cancer in the family. I did see a breast surgeon, who was convinced they were only cysts until she actually tried to aspirate them and found they consisted of semi-solid tissue. She biopsied the two in my right breast, which came back benign but "favored a proliferative process". The breast surgeon advised me to stop taking the birth control, even though they do not contain any estrogen.
Meanwile, my endo symptoms are flaring up worse and worse. Along with the traditional pain of endo, I get basilar-type migraine headaches complete with aura & moderate vertigo. I know that somehow the migraines are connected because I do not get headache or vertigo while I'm on birth control. In addition, I have major GI problems, I think due to my prior surgery when my bowel was partially disected. My GYN is concerned with my quality of life issues and is persuading me to go back on the birth control. He does not believe it was the cause of the lumps in my breast but I am afraid.
I am awaiting results of a follow-up breast sono. I am at a complete loss for what to do. Any thoughts or ideas on this would be greatly appreciated.
Thank you. I know about FBD - I've had fibrocystic breasts for many years with multiple cysts that have come and gone. I've also had 2 fibroadenomas that were surgically removed about 20 yrs ago. My concern is that these are not simple cysts but have solid material and septation that may not likely go away on their own.
Has anyone had complex cysts that have disolved over time? Does anyone know if synthetic progestin pills contribute to proliferative changes in the breast? Any insight would be great. Thank you so much.
(((Faith106))) Have you had a hysterectomy? This is a hysterectomy support website, so responses you receive here may not match your own circumstances. This is an important distinction since you asked about the use of birth control pills, and those carry a certain risk/benefit profile that is different for women who do not have a uterus.
I have not had complex cysts, but have had breast cancer twice since my hysterectomy seven years ago, and am on estrogen replacement. It's not the estrogen in (some) birth control pills that can contribute to an increase in breast cancer risk. In the women in the WHI study, it was those on the combination HRT Prempro (Premarin plus the synthetic progestin Provera) who had the slight increase in risk. The women on estrogen alone did not have any increase; in fact, they had a slightly lower risk, and those in that group who did get breast cancer had a higher survival rate.
So, the researchers have now concluded that it's the synthetic progestin Provera (aka medroxyprogesterone) which caused the increase in risk. (My DRs and I attribute my cancers to several years of Provera use in the 1990s, before we knew better.)
Your situation, with endo, is a tricky one, because progestins can help keep the endo from growing. So, it makes sense that your DR would have you on birth control pills with no estrogen and a synthetic progestin. However, you have to be aware that that *may* increase your risk of breast cancer.
Have you consulted an oncologist and/or an endo specialist about your risks? You might consider doing that before deciding about whether or not the bcp's are the right solution for you.
Thank you so much for your reply. I have not had a hysterectomy but I am considering one. I am debating whether or not I should keep the one ovary I still have. I am confused about the hormone-breast cancer link. I thought it was estrogen that increased your risk and was not aware of any connection to progesterone.
If I do have a complete hysterectomy, which I am seriously considering - what is the best way to deal with surgical menopause? (I am 42.) If I need hormone replacement therapy, should I take estrogen alone or with progesterin? Where can I get more information? My GYN and breast surgeon seem to disagree. Iam just so confused
It's not progesterone that the risk is linked to - it's a synthetic progestin called Provera, aka medroxyprogesterone. It's a molecule that can be made from progesterone and has some of the same actions in the body but also some others that are unique to it.
There are also theories about how the cancer cells get started related to particular metabolites of estrogen, but no good studies to point to that prove a connection.
I'd encourage you to post a thread in our Hysterectomy Options and Alternatives forum to get input from others on the hysterectomy/oophorectomy decisions you may be facing.
My experience is different in that I had the hyst/BSO first and the breast cancer after, but I can tell you that I've seen two oncologists and both of them said that if I still had working ovaries, they would not be pushing for me to have them removed.
How you deal with surgical menopause will depend on your individual risk factors and also which symptoms you have and how bad they are -- we're all different. For me, estrogen replacement is a requirement since the symptoms are so severe I cannot function on a daily basis if I try to even decrease my dosage, but not everyone has the same experience. Your endo history, which I do not share, will also be a factor in the decision, as most of us do not need progesterone or progestins post- hyst/BSO but you may.
Also, I'm lucky in that my DRs support my use of estrogen -- not all doctors are so enlightened -- so if you have an on-board source of estrogen that works and are worried about dealing with surgical menopause, you may not want to chance removing them and then not being able to find a DR to help you deal with the symptoms.
Thank you so much for your replies. You have been very informative. I actually looked up the WHI study that you mentioned and learned some things I didn't know. I am trying to weigh my options very carefully but I can't NOT do anything - my endo symptoms are becoming disabling and I worry about damage to more organs. I will be sure to ask my doctors lots of questions.
Thank you for sharing your experience and I wish you well.