Breast cancer and Hysterectomy

[Imorsh]

Dear all

My mother has been diagnosed with stage 3 breast cancer (Her2) approx. 18 months ago. She is towards the end of her herceptin course. It is also our understanding that she has been suffering from thickening of her endometrial lining. It was simple hyperplasia and now the line has further thickened with bleeding. She is 57.

Wanted to know if she could go through Hysterectomy if prescribed by doctor? Any risk from hormonal perspective?

Please advise.

Kind regards,

I

[roxboxfox RadiationOncologist]

Hi IMORSH,

Hats off to your mom as she approaches towards the end of her Cancer Treatment journey and perhaps soon Acchhe Din will be back for her as she becomes cancer free.....

You have nt specified the ER/PR status.

1. Usually if someone is young (Premenopausal) and ER/PR +ve we prescribe Tamoxifen. With Tamoxifen, the estimated Annual risk for Endometrial Cancer is around 2 per 1000 women.

2. For someone older (postmenopausal) and ER/PR +ve, we usually prefer Aromatase Inhibitors (Letrozole / Anastrozole) as there is no such excess risk of Endometrial cancer.

3. For someone ER/PR -ve , again there is no such thing like Hormone, and hence no such excess risk of Endometrial cancer.

Your moms risk for endometrial cancer is as good as average risk mom of your neighbours or mine, should she be in the latter two categories.

None the less, she has endometrial thickening, bleeding and this is usually taken seriously in any postmenopausal lady..

Suggest: See a qualified Gynecologist and seek opinion and if they recommend Hysterectomy, do it...

There is no impact of Hysterectomy on her Breast Cancer.

Please insist on getting her ovaries removed, should you be going for Surgery as there are different types of hysterectomy, and they may want to do a simple hysterectomy, etc etc

Wishing your mom all the best

[Imorsh in reply to roxboxfox]

Thank you kindly for your response. Really appreciated.

She is ER, PR negative and Her 2 positive. You nonetheless covered all the combinations.

I understand hormonal status could change further down the line? If it is the case, do we need to get this checked again.

Finally, we plan to see an experienced gynecologist in Kolkata.

Do you have any recommendation please?

Kind regards,

I

[roxboxfox RadiationOncologist in reply to Imorsh]

The recommendation needs to come from Gynecologist.

If it's Hysterectomy..you should opt for it.