Doesn't ERT alone set me up for breast cancer?

Hi all,
Just trying to understand...

If I get a hysterectomy because of Complex Hyperplasia with atypia (pre-cancer), and go on estrogen replacement therapy, doesn't that set me up for breast cancer next?

My research leans towards estrogen dominance being the cause of complex hyperplasia with atypia. And currently (before a hysterectomy that's coming soon and being in menopause), I am on bio-identical HRT (estrogen and progesterone), so technically my estrogen has not been unopposed. None of the doctors I have gone to have ever checked the levels of my hormones. That is very frustrating. Especially since... here I am now with complex hyperplasia with atypia.

If I sound angry, I am.

What are the hormone choices after hysterectomy for women with breast cancer concerns?

Thanks,
Goldenlife

Hi Goldenlife, Your question on HRT is a very controversial one. I did a lot of research before starting on a bioidentical HRT regime, especially since my Mother had breast cancer. She had it in her 60's, long after her estrogen supply ran out. There are studies that show that a large incidence of female cancers occur after a woman's natural estrogen depletes. I started on HRT last summer after suffering from a host of symptoms that no one could answer to. It was only after I found a hormone specialist that it was discovered that my hormone level was extremely low, in fact uncharacteristically low for my age. The thought is that all the years I stayed on oral contraceptives to "control" my fibroids/bleeding messed with my hormone levels. If you check out my signature, you'll see that it didn't help at all. My fibroids grew to be massive and I felt terrible for years (until the HRT starting reversing things).

My HRT DR believes: "Aging women should feel confident that bioidentical hormone replacement, when appropriately prescribed, offers a safer and potentially more effective alternative to conventional hormone replacement than with non-bioidentical hormone drugs to help relieve menopausal symptoms and optimize long-term health. The addition of several proven nutrients (such as vitamin D) to a bioidentical hormone regimen can help optimize estrogen metabolism and reduce cancer risk further offering a balanced approach to health maintenance."

That being said, she also has me get bloodwork regularly to keep checking my hormone levels. My dose is altered as necessary. She likes to see her patients quarterly, and only prescribes 3 months of HRT at a time so you have to keep getting tested. Perhaps that will change in the future, but I am still not to my 1 year anniversary on HRT and my hysterectomy this Spring changed my levels. I am also tested 2x's per year for my vitamin D level and have been on prescription mega-doses as needed.

I'm confused why no one has checked your levels. Do you go to one DR for your HRT? (My GYN does not believe in bio-identical hormones, only traditional pharma. So I sought out another DR for her speciality in hormones. My GYN knows what I'm doing and we have agreed to disagree.) Is the DR you get yor hormones from a specialist? If not, perhaps you might consider finding a specialist.

Good luck!

Hi ShatziLKF,

Thanks for some food for thought.

My doctors are the military. They only work with traditional pharma and only prescribe what is in their pharmacy. It is impossible to get them to work with anything outside that boundary. My last doctor only got his information off of a government website (implying that any independent studies were invalid if they weren't paid for by the government). I did switch doctors after that. We could downgrade our insurance coverage, but pay a whole lot more. I may just explore going to a doctor without using my insurance to get hormone care.

I see a gyn/onc at a military hospital next week for my consultation. I'm hoping he will be more interested in my hormone levels than the gyn clinic. I'm also hoping he might be willing to try high dose progesterone therapy to possibly try to reverse my situation before surgery.

I'm kinda grabbing at straws... I'd like for this to just go away. I'm doing me research on testosterone also (in case they have to remove my ovaries).

Part of my issue is probably genetics. I don't want to face that either. My mother died at age 40 (reproductive cancer, hysterectomy, colon cancer). Her mother (my grandmother) had breast cancer at age 80 and had her entire breast removed, radiation therapy and recovered.

My mother's side of the family leans towards some cancer issues. I just don't want to keep setting myself up for the next cancer and the next cancer...etc. That is why I was asking about the estrogen therapy and cancer.

Thanks,
goldenlife

There are bio identical hormone replacements that are available thru a regular pharmacy. Vivelle Dot, Climara, Estrace, Estrogel, Divigel are but a few. One does not necessarily need to do Compounded Hormones to get bio identical.

That said; I did go outside of the box, ended up at an OsteoPathic doctor for my hormone needs. She has been a blessing. As is my Accupuncturist. I do pay more out of pocket for these doctors, but to me it is worth the cost.

I guess at some point we all just have to play the cards we are dealt and do the best we can.

I can't live in fear of what might happen to my breasts down the road if I do this or don't do that.

I've been on bio-identical HRT for over 6 years. That really helped me to have the best quality of life since I went the route of early menopause (hot flashes, bone density, vaginal dryness + other issues). I was using products through regular pharmacy (not compounded).

I guess I will just wait and see what body parts are left after surgery and move forward from there. I'm prayerfully hoping this new doctor (gyn/onc) will be willing to deal with hormones or at least hand me over to a doctor that will test, monitor and adjust them for the best quality of my life.

Thank you for sharing...
goldenlife

I don't know the answer to your question and I don't think the medical profession has a unanimous agreement about HRT. What I do know is this is not about your breast or your reproductive organs, it's about your LIFE.

I had both endometrial and breast cancers last year, diagnosed 4 days apart. Both were estrogen receptor positive. I was post menopausal. I did not take HRT. I still got both cancers and they both loved estrogen. They had been exposed to it for many years because I had a late menopause and was overweight. I now take Arimidex so I should now have absolutely zero estrogen to feed them (I hope there's not a single cell left to feed). Estrogen is out of the question for me. I'm lucky that I'm tolerating the Arimidex well.

Imagine how aggressive those cells might have been had I given them extra estrogen, too! I've heard that vaginal estrogen cream is ok for some (not me) because it's not systemically absorbed but takes care of the issues of dryness. Maybe you can safely have that. Your gyn onc will know.

Good luck.

Suzanne

Wow...Suzanne,
Your experience implies that whatever the choices - at the end of the day, it doesn't really matter if you have cells that are estrogen receptive.

The HRT might or might not cause these issues. The estrogen is there all around us even if we aren't specifically adding it or producing it on our own. It might be environmental also.

It sounds like the key is going to be to make the conservative choices that might help with quality of life and monitor... monitor... monitor for anything that loves the estrogen or progesterone.

Thanks for your thoughts. I was really trying to grasp how I got to this place. I have spent the last year working to reduce environmental estrogens and have never taken the estrogen unopposed. Yet... here I am.

The final frontier is the genetics as my mother's family line seems to be the weak link.

Thank you for helping me to put it all into perspective.

XOXO
goldenlife