Surgical menopause, breast cancer, mastectomy and opprectomy then take HRT

[ipsoblamange]

Just had double mastectomy which apparently has rid me of the BC, no chemo or radio needed. Had ovaries out and hysterectormy (for good measure due to heavy periods), prophylaxis as I have been told BC likely genetic.

I want to have HRT, as osteoporosis runs in the family and I would rather take my chances on the BC front.

Anyone done this, take HRT after BC?

Feeling increasingly rubbish without the hormones.

[CreepingClematis]

You need to see a specialist gynae or oncologist to answer this.
The risk of BC with HRT is very small. If you have no uterus you only need oestrogen. Many studies have shown a reduced risk of BC when using oestrogen -only HRT. I'm not a dr but would think your risk of BC is almost nil- I mean, you have had surgery so how could you get BC now? (sorry if that sounds crass but I don't understand !)

[Musicaltheatremum]

No way would you get HRT. sorry. It's an absolute contraindication. You don't get a reduced risk of breast cancer with oestrogen only HRT you just don't get as great a rise. (I'm a GP) Creeping, sorry but that's just total misinformation you have given.
There are other ways of preventing osteoporosis and if you have an early menopause or FH you could be eligible for a DEXA scan to check your risk. If you need other menopause help a specialist menopause clinic could help.
There is always a risk of a few latent breast tissue cells lying around after surgery, and if you give them oestrogen then they could cause problems.
Try the menopause matters website

[CreepingClematis]

Musical You mentioned Menopause Matters as a course.
Please see this diagram of risks of HRT. You will see there are fewer cases of breast cancer in women on oestrogen only HRT. There are fewer cases compared to the base line population of women not on HRT. This information is also in the NICE menopause guidelines and the WHI trials, as well as other research papers.

www.menopausematters.co.uk/pdf/Understanding%20Risk%20of%20Breast%20Cancer.pdf

[CreepingClematis]

source not 'course'.

[CreepingClematis]

See also this
patient.info/doctor/hormone-replacement-therapy-including-benefits-and-risks#ref-30

See ref [30.] Use of oestrogen-only HRT in women who have had a hysterectomy.

I am not saying the OP ought to use HRT but it's important that anyone reading this is correctly informed.

[Mysillydog]

Creeping your links show that for an average woman HRT is a safe treatment with low risks for developing breast cancer. The OP is not an average woman, she is a woman who has had breast cancer. Your links do not state that HRT is safe in women with a history breast cancer. What Musical writes is exactly what I have been told by doctors. I have bc and my cancer is only borderline hormone driven but enough to avoid hormones and to probably need tamoxifen.

OP I would chat to your GP or onc about your concerns regarding osteoporosis and managing your menopausal symptoms. I'm sure they will have some advice. I've heard some women swear by wearing magnets in their pants to manage hot flushes, but I'm a bit sceptical about that! I think they are called Ladycare magnets, could be worth a try but probably snake oil. You have my sympathy, a medical menopause is fairly unpleasant so I'm sure a surgical menopause is a whole level more of horrible.

[CreepingClematis]

Mysillydog- am aware of what the links show. To be fair, my first post to the OP asks questions of specialists, rather than insists she uses HRT!
I posted the links so the other poster ( the dr) could take a look. There are two issues- women who have had BC and women who haven't - so hopefully those links give some clarity. It's a very grey area - some research says it's acceptable to use HRT in the short term.
The OP needs expert advice and tbh I'm shocked that she's had all this surgery and not one of her consultants seems to have discussed the issue of 'what next' so she has to come to a forum to ask.

[Musicaltheatremum]

Mm mm not convinced about the 4 fewer. Looking at the studies there was quite a range (-11to +8 ) and in an observational study there was between 1 and 12 more.
The summary presented to me at a course I attended 2 weeks ago said that oestrogen only HRT is probably associated with little or no change and it depends on the length of time you are in the HRT. also these are just changes from the baseline rate which is very varied depending on your risk factors.

[CreepingClematis]

Well, you will have to believe what you will. There are numerous studies that do show a reduction and my meno consultant is of the same opinion. The link from the Women's Health Concern is the 'patient' arm of the British Menopause Society so I'm inclined to think they have studied all the available evidence before producing that graph.

[GraceGildee]

I had similar surgeries to you for ovarian cancer. I have found starflower oil capsules from Holland and Barratt very very helpful, if I forget to take one my symptoms are much worse. I was told no HRT too.

[ipsoblamange]

bit of a busy time, sorry for not checking in

musical, there is differing medical opinion on HRT, I am lucky enough to have just seen one of the leading breast cancer oncologists, who is a professor at a leading cancer hospital, interestingly their view was that the risk to me of not having HRT in particular my bones and quality of life was far greater than the remote risk of a cancer recurrence - which in my case with the cancer I had my risk of a new cancer or recurrence is so remote that I don't even need tamoxifen (with or without the ovaries - no ovaries though - sadly)

the risk of moderate alcohol consumption poses a greater risk than HRT does for breast cancer

I have to say that sadly, after five weeks of honeymoon, post oophrectomy I am now having a hellish time. I have hit a wall. I feel like I am going to go mad and physically the symptoms have hit I thought I had got away with it!!. Medical opinion is divided on HRT and breast cancer (and I have been on zilch) but now that I have the oncologist on side and have I tracked down one of the few gynaecologist who knows how to deal with this issue - he is apparently so good at HRT (particularly for women like me) his waiting list is six months - i feel like i need to have an electronic second counter to keep me going until I see him - but I now have hope

I do feel sorry for all those women out there who are turned down for HRT, for some that is appropriate but I suspect for many there are arguments either side and they should be given the evidence and be allowed to make an informed decision themselves

There are valid views on both sides, however, ultimately it is up to the individual to weigh up the risks and benefits and for me and the particulars of my cancer the risks of not having HRT far outweigh the risks of having it.

Thanks to all of you though, on both sides of the discussion, for giving up your time and for posting

Ipso xxx

[CreepingClematis]

ipso I'm really pleased you have had some expert advice. As you say, the risks need to be put into perspective and there is not just one school of thought on this. Different consultants have different views because the evidence is grey rather than black and white.

I assume the consultant you are waiting to see is Panay who does a lot of research on HRT and runs an NHS and a private clinic. I know of him professionally and he's very well regarded. I'd have a word with his PA if you haven't already to ask for cancellations or maybe you could afford an initial first appointment privately? (It's still a long wait I understand.)

Good luck with it all.