Having ovaries removed - uterus, too?

I have a BRCA -1 gene mutation that puts me at a high risk for breast and ovarian cancers (not unterine).

I am going to be having a double mastectomy and my ovaries removed. The gyn/oncologist that will be removing the ovaries (and tubes) said that it is optional to also have the uterus removed, and my decision.

I'm looking for any feedback anyone might have to help me weigh the pros and cons...

Thank you!

Hi I'm sorry to hear you are facing such a difficult decision. When you talked with the gyn/oncologist, was there any discussion of how you will deal with the symptoms of surgical menopause plus ensure continued health of your skeletal and circulatory system without your ovaries? Also, will you be prescribed any medications as a preventative, including perhaps Tamoxifen? Sometimes it is prescribed to try to reduce the likelihood of future breast cancer.

The reason I asked about Tamoxifen in particular is that it is known to greatly increase the odds of getting uterine cancer, so some women who take it opt to have a prophylactic hysterectomy so they won't have to worry about that. The other consideration would be that if you decide to use HRT to control your menopausal symptoms (let's just say that despite the best laid plans, sometimes the symptoms turn out to be much more than we've bargained for and plans change ), if you still have a uterus the HRT will need to include some type of progesterone or synthetic progestin to protect from endometrial proliferation due to unopposed estrogen. That being the case, many women end up taking Prempro if they still have a uterus, and the Provera component of Prempro has been associated with a slight increase in risk of breast cancer, making it a poor choice for you.

The decision can be complicated. Good for you for doing your homework and taking your time to make the right decision for you.

Good luck with whatever you decide to do.

s,
-Linda

Linda, Wow - I'm so glad I'm here! Its obvious to me in reading your response that I have sooo much to learn. I guess I knew that already, though.

When I met with the gyn/oncologist, there was discussion regarding HRT - although not very specific. He stated that if I choose to use HRT, I'll need estrogen only if I have both the ovaries and uterus removed, as opposed to estrogen and progesterone if I only have the ovaries removed. He also stated that HRT will be a choice, not mandatory.

I don't know what HRT's he will suggest, but I did ask specifically about Tamoxifen (because my sister is currently taking that) and was told I don't need to take Tamoxifen, as long as I'm having the ovaries removed in the near future.

HRT is a subject that I need to start getting a lot of information on as well. To do - or not to do???

Again, Thank you!

Lisa