[Becky]

Mary Jo

I had my ovaries removed but for several reasons you don't have. The first is that I am only moderately ER+ but PR neg and it is well known that if you are also Her2+ with that kind of hormone expression, Tamoxifen does not work and can also produce the opposite effect (of helping the cancer grow). AI's or Faslodex work better in this case but you have to be postmenopausal (which I was not). Secondly, my paternal grandmother died of ovarian cancer. Thirdly, my gyne saw 2 objects which he could not identify on ultrasound (they ended up being follicles that did not ovulate - probably occured during a chemo session when that ovary said "No way - we ain't doing this anymore"!). Lastly, my uterus (which I still have) was thickened (15 mm when the highest measurement for "normal" is 5 mm). Thickening is usually caused by high or flucculating estrogen levels (usually during the perimenopausal time - Tamoxifen can make this even worse and cause cancer).

You do not have any of this. However, you should get the BRCA 1 &2 testing. If you are positive, you should have your ovaries removed because BRCA does not only cause bc but ovarian cancer as well. I did not test positive for the BRCA genes but did it anyway for all those reasons.

I believe however, that barring sound rationale, it is better to go through menopause naturally because your body chemistry is natural. I realize I am being slightly hypocritical as I had my ovaries removed but if you were like me, I would advise the same (and tell you to get your ovaries removed). Get BRCA tested and get your gyne to do a transvaginal ultrasound of your ovaries to see what they look like (and do the CA 125 tumor marker for ovarian cancer too). Take your time with this decision and talk to all your doctors on their opinions too.

Love,