TAH & BSO 10/7/10, Surgical Menopause, Currently HRT, also BRCA positive .

I have a lot happening at once & am wondering if anyone is in the same situation or might have some advice. Having 2 sisters with breast cancer, last spring I took the genetic test to find that I carry the mutating gene for breast/ovary cancer. Also in the spring I to deal with reoccurring endometriosis issues, etc which has led to my hysterectomy this fall - as a result the concern for ovarian cancer has been eliminated. However, I am concerned about taking hormones with the risk of breast cancer being higher for me. Shortly after surgery, I felt hit hard with menopause - migraines, depression/moods, major night sweats, etc. I did begin HRT a week after surgery - using Evamist (first HRT spray approved by FDA and contains estrogens made from plants). I have had great improvement but can't help but wonder if this is the best low-risk therapy I can use. Anyone?????

I also am BRCA positive. I am a labor and delivery nurse and have a really good friendship with my OBGYN who did my surgery. Her and I both did a great deal of research. I am 33 and while I wanted to remove my ovaries I was worried about my reaction to surgical menopause. I decided to start bio identical estradiol. I started the climara patch. There are a few really good studies from yale. It is a really personal decision to start hrt when you have the risks we have. I get a mammo and a breast MRI each year staggered from each other. I had my LAVH, BSO, TOT, and A&P repair the day before you did. For me it is worth it to have my sanity.

So glad to hear from you!
I am not familiar with bio identical estradiol. Can you highlight what it is? I did begin a plant-based estrogen mist a week after my hysterectomy (no in my 3rd week post-op). It is called Evamist. My gyne is aware of my family history & my BRCA results so I am relying on her to make the best suggestion for me - but I am concerned about anything being overlooked. I did arrange to see an Oncology Surgeon at a breast care center but won't go to that appt until the end of February. Hopefully he will have further input on what is best for me. I definitely want more involved testing than just annual mammograms - which is all I have had over the years. I like your precautionary measures of having an MRI. How long have you been doing this?
Look forward to hearing from you!

Bio identical estrogen is not made of horse urine. Premarin and a few others are made of the urine of pregnant mares. I went to the breast health center at Naval Medical Center San Diego. They recommended that I get my mammo and then six months later get the breast MRI. My mom had breast cancer at 38 so I started this at 28. When I was breastfeeding they did breast ultrasound. Most of the studies out there advocate bio identical for those of us that are BRCA positive. HRT is very personal in this situation.

Allison

I agree...it is personal for everyone! It can be confusing & overwhelming because of all the options yet we are so fortunate to have so many options!! Do you mind sharing the studies you have learned from concerning the BRCA & treatments recommended?

I have struggled for the last year whether or not to try some HRT. Have BRCA 2. Had the TAH 8/09
Finally, due to dry vagina/ uncomfortable sex, my doc agreed to let me use Estrace Cream, 1/2 gram a week..Lowest dose. Not sure if it's doing anything yet. It's only been 3 weeks.

Thank you so much for your information. I will share it with my doctor at my next post-op check. I am still using the lowest dose of EvaMist and having great results - but of course, have the concern in the back of my mind about the risks & BRCA positive/family history. It helps to be aware! Thanks Again!

I am in the same boat--had a BSO 2 weeks ago, I am BRCA 2 +, my mom is in the last stages of OC.

I was told that by removing that my ovaries this decreases my chance of breast cancer by 50%--and that I have the same odds (25%) as the general public.

Also in my reading the type of breast cancer that BRCA 2 develops is slow growing (very slow) and can be picked up on breast MRI, and ultrasound etc.

Also I learned the menopausal symptoms are VERY intense with surgical menopause--but last about 2 years as compared to the longer regular menopausal symptoms--so ones need for HRT--etc--would be much shorter in duration.

It has been 3 weeks post op--and I feel awful with the night sweats/hot flashes (like 10 a day), lethargy, depression (which I have at baseline)..

Other variables include: selling my home, having a back injury, being chronic pain, my mom dying and so on...but I have a supportive husband and mother-in-law--it is taking a toll on him--how could it not...

I am so thankful for this site--and look forward to any comments or questions...

Many thanks...

Hey ladies, I'm a Brca 1 too. Just wanted to join the thread. Also, if you haven't been yet, you should check out facingourrisk.org too: its like this for Brca folks.
I'm about 8 weeks out, the menopause sucks and I'm still debating hormones. My gyn/onc said no hormones unless I really can't deal, but then some articles and force folks have said that hrt doesn't increase my bc risk enough to outweigh the need for estrogen as a younger person.... craziness. Anyways, trying to figure this stuff out too, just wanted to join my Brca sisters on here.
Grace and peace