Why get an oophorectomy?
Meet the Experts
Sandra F. Schnall, M.D. is a medical oncologist/hematologist who practices at Bryn Mawr Hospital in the Thomas Jefferson University Health System outside of Philadelphia, Pennsylvania.
Marisa Weiss, M.D. is a radiation oncologist specializing in breast cancer and the founder, president, and guiding force behind Breastcancer.org.
Question from Kimmy Too: If tamoxifen is a "medical" oophorectomy, then why in the world are my medical oncologist and my radiology oncologist insisting that I have my ovaries removed?
- Answers —Sandra Schnall, M.D.: In a pre-menopausal woman, oftentimes the tamoxifen does not complete menopause and, therefore, sometimes we need to add other hormones such as Zoladex. In a pre-menopausal woman, the oophorectomy may be simpler to perform than taking combined-modality hormones. If the ovaries can be removed laparoscopically, that makes it more ideal than an incision-associated removal through major surgery.
- Marisa Weiss, M.D., president and founder: There may be other reasons why your doctor may suggest removal of your ovaries as well as fallopian tubes. For example, if there is a proven breast cancer gene in your family, and if you also have the gene, and if you are finished childbearing, your doctor might recommend this type of surgery to substantially reduce the risk of ever getting ovarian cancer. Removal of the ovaries in a pre-menopausal woman with a breast cancer gene abnormality also substantially reduces the risk of ever getting breast cancer.
If you are a young woman who has had breast cancer that is hormone-receptor-positive, and if your oncologist is recommending that your ovaries be shut down in order to reduce the risk of breast cancer coming back, I would recommend trying to shut your ovaries down with hormonal therapy rather than removal of the ovaries.
This is because you might want to have children at some point in the future, and, in general, removing the ovaries would take away your ability to bear your own children with your own eggs in the future. We are working hard at figuring out how to freeze eggs and ovaries in special banks to keep alive the hope of having children in the future with your own eggs. But there's a lot more work that has to be done to perfect that.
On Wednesday, April 21, 2004, our Ask-the-Expert Online Conference was called Hormonal Therapy Updates. Sandra Schnall, M.D. and Marisa Weiss, M.D. answered your questions about hormonal therapies and answered questions about which ones work best in different situations, how they might fit into your treatment sequence, how to deal with side effects, and more.
The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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