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What Are The Chances Of Cancer When Diagnosed With Ovarian Cysts?

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Posted on Wed, 12 Mar 2014
Question: My wife, who will turn 48 next month, has been on tomaxifen for 4.5 years (breast cancer in 2009). Now she is diagnosed with ovarian cysts and a thickening of the uterine wall and has to go for a CA 125 test and a biopsy. We are worried (me more than her, quite frankly). What are the chances that she has cancer? What other possibilities are there? She is not obese and does not drink or smoke.
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Answered by Dr. Timothy Raichle (1 hour later)
Brief Answer: Hello, I would be happy to help... Detailed Answer: Tamoxifen is associated with changes in the lining of the uterus. These changes include thickening of the lining, polyp like changes, and an increased risk for pre-cancerous or cancerous changes of the lining. Consider that the risk of uterine cancer in women aged 50-70 is about 1.4%. Being on Tamoxifen doubles this risk. But consider that this means that her risk is still very low at 2-3% chance. I would consider this reason #1 to not panic or worry yet. That being said, given that Tamoxifen therapy is a risk factor for developing uterine cancer (above the baseline rate) then it is important that she have an endometrial biopsy performed. If this biopsy is negative, it would still be warranted to schedule her for a hysteroscopy to evaluate the exact cause of the thickening of the lining. In most cases, this is going to be polyp like changes. With regard to the ovarian cysts, these are probably less of a concern. But, without knowing more details (their size, complexity, etc.) I cannot say exactly what I think about this part of the story. Understand, though, that tamoxifen is NOT associated with ovarian cancer, and the chance of ovarian cancer is statistically LESS than breast cancer (except in those patients with a genetic predisposition). I hope that this helps!
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Timothy Raichle

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What Are The Chances Of Cancer When Diagnosed With Ovarian Cysts?

Brief Answer: Hello, I would be happy to help... Detailed Answer: Tamoxifen is associated with changes in the lining of the uterus. These changes include thickening of the lining, polyp like changes, and an increased risk for pre-cancerous or cancerous changes of the lining. Consider that the risk of uterine cancer in women aged 50-70 is about 1.4%. Being on Tamoxifen doubles this risk. But consider that this means that her risk is still very low at 2-3% chance. I would consider this reason #1 to not panic or worry yet. That being said, given that Tamoxifen therapy is a risk factor for developing uterine cancer (above the baseline rate) then it is important that she have an endometrial biopsy performed. If this biopsy is negative, it would still be warranted to schedule her for a hysteroscopy to evaluate the exact cause of the thickening of the lining. In most cases, this is going to be polyp like changes. With regard to the ovarian cysts, these are probably less of a concern. But, without knowing more details (their size, complexity, etc.) I cannot say exactly what I think about this part of the story. Understand, though, that tamoxifen is NOT associated with ovarian cancer, and the chance of ovarian cancer is statistically LESS than breast cancer (except in those patients with a genetic predisposition). I hope that this helps!