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[Lostit]

10 years ago I was diagnosed with DCIS, a non invasive breast cancer. I was going through life quite nicely after surgery until menopause literally 'hit' me. I was incorrectly diagnosed with labrynthitis, possible ms and fibromyalgia. Not one Dr said that my symptoms coupled with extreme anxiety, nausea and panic attacks could be menopause.
I have struggled on 10mg of citalipram for 2years now. 20mg had me in such a state I ended up in casualty.  I have recently started to up my dose to 20mg again as I have had some real dips of anxiety accompanied by a return of hot flushes.
The breast clinic have said no way to me taking any form of HRT and I would be interested to know from any other ladies on here who have a history of breast cancer, what their own experiences are and if any have actually taken hrt
Thank you all

[CLKD]

Quality of Life is important.  Maybe ask the breast clinic exactly how they know that you will be affected if you have to take HRT?  I don't think that clinicians are aware of how debilitating menopause symptoms can be.  They get fixed in the 'no HRT because ....... ' and some of that may be due to the possibility of litigation!

If the Clinic are relying on past research regarding the risks ...... they are out of date!  I would have an appt. and ask to see exactly why they are not recommending HRT.  As I left my last Oncology Appt in 199? whatever, he said 'no HRT for you'.  I thought, we will see.  Fortunately I haven't had a recurrence nor have I had such bad meno symptoms that have driven me to require treatment, other than vaginal atrophy.

[Taz2]

Hi Lostit - so sorry you have had such a tough time. Advice does seem to be that if you have had DCIS then oestrogen is not recommended but, then again, reading up on some sites the evidence seems a bit sketchy. I have found this site today https://breast-cancer.ca/progfacts-dcis/ which gives what seems to be up to date advice. If you scroll down some way you will find this statement

"There has been extensive research in the past regarding the connection between women taking hormone replacement therapy (HRT) after menopause and invasive breast cancer.

survival rates for ductal carcinoma in situHowever, there are very few studies that have examined the risk of HRT associated with Ductal Carcinoma In-Situ. A 2012 study examined 1,179 post-menopausal women with Carcinoma-In-Situ.

The study found no association between DCIS and use of Hormone Replacement Therapy (including estrogen alone and estrogen and progesterone combined therapy). Furthermore, there was no association with current use of HRT or the duration of use of these hormones.

However, the study concludes that larger clinical trials are needed to truly assess if there are any associations between HRT and DCIS.

In addition, the age of menarche has not been shown, so far, to be associated with DCIS incidence. Indeed, it is more likely (3.7 times) for women over 60 to develop DCIS."

It is a Canadian (I think) website but it's worth gathering as much info as possible. Apologies if you have already seen it!

If HRT is not an option have you been offered Clonidine (Dixarit) which is a blood pressure medication but is also good at relieving menopausal hot flushes?

Taz x

[Hurdity]

Hi Lostit

In addition to the suggestions made by Taz, there is a review of medication which is good for flushes and sweats and with special reference to women who have had breast cancer and may be unable to take HRT, or are taking tamoxifen.

Here is the link:

Consensus statement for non-hormonal-based treatments for menopausal symptoms:

http://journals.sagepub.com/doi/full/10.1177/2053369117711646?hootPostID=6690d93930a10b86869c48433ab506e7

The relevant summary paragraph  about SSRIs and SNRIs is here:

"Since paroxetine is the SSRI with the best evidence for efficacy19,23 effective at 10 mg daily, it is the SSRI of choice for patients not taking tamoxifen and the more usual 20 mg dose chosen if an antidepressant effect is also required.

Venlafaxine is the preferred treatment for breast cancer survivors taking tamoxifen, and at 75 mg, there is significant reduction in hot flushes with concomitant improvement in fatigue, mental health and sleep disturbance."27



Hurdity x

[Lostit]

Thank you ladies. As ever you are very knowledgeable.  I have a gp appointment in a couple of weeks and can go armed with a few more facts.

[Tempest]

Hi, Lostit.

I'm so sorry you're having such a struggle! I can confirm that a lot of ladies who have had breast cancer on the breast cancer forums have benefited from Venlafaxine specifically in helping their menopause symptoms - often eliminating their hot flushes completely. And it seems to do well in small doses for anxiety, too.

The dose prescribed for this is comparatively small - 37.5mg to max. 75mg. Do have a chat with your prescriber about it and see if you might like to give it a go. xxxx