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Diagnosed With Stage 2 Breast Cancer. Not Feeling Good After Treatment. Should I Be Worried?

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Posted on Thu, 9 Aug 2012
Question: Hi l am 49 was diagonosed with stage 2 breast cancer at 43 no lympth node invasion, treated with a lumpectomy, radiation tamoxifen and triptorelin injections every 28 days as part of SOFT Trial to stop ovalation it send me through chemical induced menapause. Now five years Iater finishing my treatment in Feb 2012. I got my period back 13 days ago and it appears to be still quite heavy. Should l be worried or is this normal given the circumstances. Looking forward to your reply. Kind regards XXXXXXX
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Answered by Dr. Ioan Dorian OANA (3 hours later)
Hello,

Thanks for your query.

The effect of tamoxifen is variable on menstrual cycling. Only a percentage of women stop getting periods altogether while on tamoxifen: 25% will continue with normal periods, 50% will have irregular periods, and 25% will stop altogether. Tamoxifen does not lower estrogen, which is a definition of menopause, so it is not causing menopause but just the symptoms of menopause. So, having your period back could be normal given your circumstances.

However, when women with breast cancer who take tamoxifen on a long-term basis , develops vaginal bleeding, then the first concern that comes to mind of physicians is that this could be a sign of uterine cancer. It is the case for heightened vigilance by the clinician responsible for your care, but you have to keep in mind that uterine cancer is slightly increased by tamoxifen use, but is still relatively rare.

My recommendation would be check it with your oncologist, just to avoid any worry.

If you have any more queries, feel free to ask.

Regards
Dr. Dorian Oana MD, PhD
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Ioan Dorian OANA

Oncologist

Practicing since :2006

Answered : 101 Questions

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Diagnosed With Stage 2 Breast Cancer. Not Feeling Good After Treatment. Should I Be Worried?

Hello,

Thanks for your query.

The effect of tamoxifen is variable on menstrual cycling. Only a percentage of women stop getting periods altogether while on tamoxifen: 25% will continue with normal periods, 50% will have irregular periods, and 25% will stop altogether. Tamoxifen does not lower estrogen, which is a definition of menopause, so it is not causing menopause but just the symptoms of menopause. So, having your period back could be normal given your circumstances.

However, when women with breast cancer who take tamoxifen on a long-term basis , develops vaginal bleeding, then the first concern that comes to mind of physicians is that this could be a sign of uterine cancer. It is the case for heightened vigilance by the clinician responsible for your care, but you have to keep in mind that uterine cancer is slightly increased by tamoxifen use, but is still relatively rare.

My recommendation would be check it with your oncologist, just to avoid any worry.

If you have any more queries, feel free to ask.

Regards
Dr. Dorian Oana MD, PhD