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Preventative surgery?
An_253010 posted:
I had breast cancer 5 years ago (ER-/PR-, HER2+) and worry about ovarian cancer. My breast cancer was treated with chemo, radiation and lumpectomy and my follow-up mammograms are fine. I am 65 years old. My gynecologist indicated that I may reduce my chances of ovarian cancer if I had my fallopian tubes removed. I have no objection to that (they are not in use anymore), but wonder whether risk is more reduced with a hysterectomy. What do you think?
Anon_6061 responded:
I'm sorry you had breast cancer. Have you had BRCA testing? If you aren't BRCA , your lifetime risk of ovarian cancer is less than 2%. And would the immediate risks of major surgery (anesthesia, blood clots, hospital acquired infection, nicking of bladder or bowel, etc) even be worth the "possibility" that tube removal reduces your risk (BRCA or not).

I had a hysterectomy 7 years ago at age 50 and wish I could go back in time and keep all my parts. This surgery turned my life upside down. For one, I aged overnight and have been plagued with bowel and hormonal problems ever since. And all sexuality is gone despite being on HRT. My husband now seems more like a roommate and we were passionate before.

Hysterectomy changes your anatomy inside and out. I've connected with so many women who've had additional surgeries or are facing additional surgeries for prolapsed bladders, bowels, rectums, urinary and/or fecal incontinence resulting from the shifting of those organs. And the surgical mesh causes more problems (infections, erosion) leading to even more surgeries.

Studies show that the ovaries of intact women continue to produce hormones into their 80's. A woman aged 70-79 has premenopausal levels of testosterone. Hysterectomy with ovary removal cuts testosterone production in half (the adrenals continue to produce some). Women who have ovaries but no uterus produce intermediate levels of testosterone. Testosterone has functions beyond sexuality.

Removing fallopian tubes may cause ovarian failure. And since fallopian tube removal "may" reduce your risk, is going under the knife worth this "possible" reduction? Especially if your risk is less than 2% (with your tubes)?

Just some things to think about.

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