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[vonnie]

Hi, I am new to this site and feel that I need advice as I am really worrying at the moment.

I had my hysterectomy at the age of 39 -due to severe endometriosis, they refused to take my ovaries as I was under 40.  I had the oophorectomy in 2012, followed by HRT starting in October 2012, I was advised that I should take HRT but must be cautious as I have three aunts who have had breast cancer (on my mums side of the family), I have also had numerous cysts aspirated.
I was started on Estradot -patch and everything was fine until I started with malasma, my consultant changed my HRT in November 2013 -for another HRT tablet.  Unfortunately, in June 2014 I had to have my medication changed again due to malasma.
I started premarin in June 2014 and everything seemed ok.  In September 2014 -I found a breast lump, I was referred to the hospital and visited the clinic -within five days.  I had a mamagram and ultrasound, the doctor informed me that my breasts were very very dense and he wanted to keep a close eye on then as I have thickening of the breast tissues. I have never heard of this -having always had aspirations etc-I have always been relieved when I was told everything was ok.  Anyway, I asked the doctor if it could be related to the change in HRT -he said it could be -be did not tell me to stop the hrt or to continue with it.  He made an appointment for me to go back in 6 weeks and told me he wants to keep a check on the tissue to see if the thickening has gone, if it is the same or if it has got worse -and if it has gone worse -what action will be taken -I should have asked -what this involved but never thought at the time. 
Anyway, I was  a nervous wreck and got in to see my GP-immediately he told me to stop the hrt, told me I would be feeling yuck -but to see him in a couple of weeks to see if he needed to prescribe something for the hot flushes etc. 
I go back to see my gp-on the 7th October, breast clinic on 16th October -I am worried sick about the breast issue, I am feeling awful -sweats are unbearable -so much so I am feeling really bad with them as well -at work today I fel like I was going to pass out-just so hot etc, then at night I am awake between 11.30/12 -to 4am, no matter what time I go bed I am awake without fail for four hours, last night sweat was pouring out of me, pillows etc were wet through -again felt really bad.  I asked the GP about osteoporosis etc-but he told me I would be ok-as I am eight weeks off 45 and normally they say if you get to 45 on HRT-you will be ok-so have been on hrt for around 22 months, at one point was advised to be on it till 50-then till late 40's, but now a sudden panic.
Does anybody know anything about these breast issues -and the relationship with HRT, also advice on HRT please, I have started evening primrose-as I have been told this is good for thickening of the breast tissues.
Please any experience, advice to help me get through the next few months -feeling exhausted all the time and no energy, get up/go etc-and lost interest in anything.
Be interested to hear other stories where people have had similar experiences.

[CLKD]

First of all welcome.  Pity you didn't ring the Consultant about the HRT.  Breast disease can be caused by many different factors, were the family members diagnosed early or later in Life? did they have oestrogen dominant cancers, how were they treated, did they die of the disease ……… all these issues will determine whether or not you need to stop the HRT.

Even so, quality of Life is important.  I don't know if the comment about osteoporosis is true, maybe ask the Charity relating to this? (name escapes me right now  ).  Have a read of the menus, left of screen and try to find out if the Consultant is aufait with the various breast conditions relative to HRT.  By seeing you on a regular basis he will get your history and be able to keep an eye on any differences in scans etc..

I know that breast conditions can scare the pants off us but in 1995 I went through cancer treatment and survived .  My consultant always said 'a healthy breast does not have any lumps'  ……… evening primrose oil capsules can help with breast tenderness.  Maybe make a list of your symptoms to take to both appts., so that you don't forget any issues.

[Taz2]

Hi vonnie - welcome to the forum.

I just want to say that the usual guidelines are that under the age of 50 HRT is thought to present no extra risk as you are merely replacing what your body should have made naturally. It is only after the age of meno, 50/51, that risks begin (as far as I know). The advice that you only need HRT until mid forties is, I'm sure, not correct. Have a look at the menu on the left of the screen for more advice re early menopause.  As CLKD says it does depend on whether your aunt's cancers were oestrogen receptive as to whether HRT makes a difference.

Some HRTs can affect the density of the breast http://www.thebms.org.uk/factdetail.php?id=5 There have also been some reports in the press over the past couple of weeks regarding the difficulty of scanning dense breast tissue so maybe this is what has concerned your consultant?

You have come to the right place here for advice and companionship. Let us know how you get on.

Taz x 

[Hurdity]

Hi vonnie  from me too

Just to add also that Premarin is an old-fashioned (and the cheapest) form of HRT - and consists of equine (horse) oestrogens.  In your position and with your family history, personally I would not want to change from a bio-identical preparation containing estradiol only (ie the Estradot) to one containing oestrogens that are alien to the human body. The data on which the risk information is based was obtained through trials where women took Premarin and related HRT containing horse oestrogens, although as Taz says the general view is that risks of HRT do not begin until after the natural average age of menopause. Also these data (from the trials) showed no increased risk of breast cancer from taking oestrogen only HRT, and it may even reduce the risk.

As well as the helpful information that Taz has given you there is also general information about risks on this site: Risks here:
http://www.menopausematters.co.uk/risks.php
Balancing risks and benefits here:
http://www.menopausematters.co.uk/balance.php

If you scroll back through the news items starting here there will also be summaries of up to date info about cancer risk:
http://www.menopausematters.co.uk/news.php

You didn't say what dose of Estradot you were on, nor the dose and type of other HRT. I haven't heard of Malasma - is that a breast condition? I couldn't find it on the web.

As always to reduce the risk of any cancer, the advice is to limit other risk factors ie reduce alcohol consumption, stop smoking, maintain weight within a healthy BMI range, take regular exercise and eat a healthy balanced diet with plenty of fresh ingredients espcially fruit and veg.

Hurdity  x

[CLKD]

'receptive' - that's the word ……..

[Linsey44]

Hi Vonie, sorry you are so worried, please try not to be.

In my own experience breast density is not automatically a pre cursor to anything but changes in breast tissue should always be monitored.  I am sure there is a thread somewhere that explains about how increases in breast density occur mostly in first year of hrt use.

Also i had lumps and mamos aged approx40/41 and consultant said thickening and hardening of tissue is normal he described it as natural degeneration of breast tissue due to aging.

i had a hysterectomy then 11 months later i had my ovaries removed and on hrt initally prescribed tibolone my consultant due to history of adenomyosis which is similar to endo in many ways therefore need oestrogen & progesterone I have BRCA2 gene mutation and several consultants said i did need hrt till natural meno age.

Tibolone worked initially but transferred to 2pumps of oestrogel and 100mg of utrogestan, i emailed dr currie fir advice then printed it off and my gp was happy to go with it.

This has improved my quality of life dramatically.

Maybe try emailing dr currie for advice

[vonnie]

Thanks for the posts and the advice and links -which I am going to read now-will be very useful.

My aunts were in their late 50's/early 60's when they were diagnosed with breast cancer -all three had previously been on HRT, two had a mastectomy and one had partial removal.  Unfortunately one aunt passed away -as a result of the cancer, one of them is now 80 and the other is 78, I don't know anything about the cancer though.

I will have to find out the strength of the patch which I was on initially, then I went on to Tibolone 2.5mg  tablets-daily, before the premarin. 

Both previous lots of HRT started me with melasma (apologies-I spelt incorrectly previously), this is the darkening of the skin-all around my top lip went brown and patches on my face also went discoloured -I had to keep out of the sun and still have some of the discolouring-which did start to look a mess -this is one of the side affects of the HRT . 

I do look after my health, I drink very little -perhaps two units a month, I am not overweight, take regular exercise, plenty of fruit and veg.

I appreciate any advice, experience etc-to help me with my worries at this moment in time, will be so glad when I have been back the hospital.

[CLKD]

Could you ask your Aunts?

[Linsey44]

Hi Vonie. I downloaded this book for my ipad and when a friend got breast cancer I bought her a copy from amazon.

Its called Anti cancer - a new way of life its by Dr David Servan Schreiber.  This is a absolutely not a book that claims to cure cancer.  It is informative, research based and very interesting as it looks to nutrition and lifestyle factors as a way of supporting our bodies.

My friend that is undergoing treatment says its her new bible and has kept her positive she has raved about it to all her friends.  It has given her something else to focus on and as a result has taken up walking etc.

Have a look at book reviews on amazon and see if its something you would like.

[vonnie]

Thanks for the posts.
I have been to see my GP -been prescribed fluoxetine-as proven that they are good for anxiety attacks and hot flushes, he had also received the report from the hospital.
The report stated that I have thickening of the glandular tissue in the lymph glands and a large lump in the gland which was very very dense.  The report stated that when I go next week it will be reviewed and if the thickening is still present then a biopsy will be taken.  The consultant mentioned that he discussed the HRT with me -in fact I told him I had recently changed hrt and asked  if this could be linked-and all he said was -it could be, the report suggests it was discussed at great lengths.
The Gp told me to ask the consultant next week if I the hrt has caused the problem, if I should stay off the hrt -or go back on it ? gp was not happy with the report -as it was so vague really. 
I am not sleeping at all-last night still awake at 2.15am -feeling drained and flushes are awful-just hoping that the tablets will help when I start them, did mention another tablet but this made mood swings and suggests to leave for the time being.
I asked two aunts -unfortunately they couldn't tell me anything else, the one who had partial removal was just told she had cancerous cells, the other one had the mastectomy and was told she had breast cancer-they don't know any further details.
Such a nervous wreck now -feel worse having heard the report from the hospital.

[CLKD]

Reports are very clinical …….. unless explained they don't mean much to the patient 

Making a list of queries to take to the appt. might help.  Hopefully the Fluoxetine will kick in by the end of the week so you can relax a little more.  Is there someone who could go to the appt. with you to take notes?

Presumably your Aunts' medical history is on file so it might be worthwhile the Consultant requesting copies with their Consent?  That way he can compare their histories with what you are presenting with.  If there is a lump in the gland, hopefully it can be removed without too much difficulty: whatever the 'biopsy' shows.  I had 5/7/or 9 lymph nodes removed and where the scar is the under-arm hairs don't grow  ……. I don't sweat that side either.

Try to rest when you can.

[vonnie]

Just making a few questions ready for the breast clinic tomorrow, still no different and flushes are awful and not sleeping at all.
Been told by GP to ask the consultant tomorrow about HRT-if they can answer it-will be surprised though, just hope the thickening has reduced -I know the lump is still there-have to wait and see.  Glad appointment is 9am-but worried sick about going and already feel bad, fainty etc. 

[Ilovemycats]

Hi vonnie

I'm new to board and just read your post.

Try sage 2x 285mg twice a day for your flushes-they worked wonders for me and whilst I still get them they r nothing like I had at first.

Good luck with your tests if u have to have any xx

[vonnie]

Thanks, I will try the sage-willing to try anything at the moment-feel so bad and just so tired and exhausted all the time. I have had a long morning at the hospital - three core biopsies-playing the waiting game now -the consultant said two weeks and the nurse said it could be three weeks -so just waiting.  The consultant wanted to see what was going on in my breasts and decided to do the three biopsies , advised me to stop all hrt and asked if I had registered with the ladies health clinic -which I have a few years ago, so just waiting now, stomach seems really upset just know its all nerves and feel really ill, and achy.  Told to rest today -so that's what I am doing now.

[Linsey44]

Hi Vonie, i think if you may need to research sage as its not normally recommended for those with a history if breast cancer.