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Suffering From Breast Cancer. Will It Be Safe To Go For Mirena IUD?
Question: Hello:
I am a 44 year old woman, had breast cancer that was ER Positive. Had Bilateral mastectomy. Not doing tomoxifin. My DR. is pushing for Mirena IUD for symptoms below, which is NOT recommended by company for woman that have had breast cancer. Can you talk a look?
Narrative
[HST]: perimenopausal DUB
[SAS]: bleeding after intercourse.
Pelvic Ultrasound.
Transabdominal and Transvaginal exam.
Transabdominal pelvic ultrasound:
The uterus measures 97 x 42 x 64 mm in length, AP diameter, and
transverse diameter respectively. The endometrium and ovaries were
inadequately visualized by transabdominal scanning. Inadequate
myometrial detail as well. We proceeded with transvaginal scanning
therefore in order to better visualize the endometrium and ovaries
and myometrium.
Transvaginal pelvic ultrasound:
The endometrium appears homogeneous and measures 7 mm in AP diameter.
There is a small circumscribed focal echogenicity adjacent to the
anterior margin of the endometrium measuring about 8 x 6 x 7 mm in
diameter. Most submucosal fibroids would be hypoechoic. It is
appearing to be located adjacent to rather than within the
endometrium mitigating against a polyp which would be more commonly
echogenic such as this. Another potential consideration could be
heterogeneous myometrium such as could be seen with adenomyosis.
Other parts of the myometrium also appears heterogeneously echogenic.
( Clinical situation could help determine if MRI of the uterus
evaluate further for possible adenomyosis is desired).Changes from
surgery remains a consideration as well. It was not demonstrated on
the prior ultrasound from 10/21
The right ovary measures 21 x 16 x 27 mm in diameter.
No right adnexal masses or abnormal fluid collections are seen.
The left ovary measures 29 x 18 x 36 mm in diameter
no left adnexal masses or abnormal fluid collections are seen other
than a presumed follicle measuring about 2 cm in diameter.
no abnormalities are identified elsewhere
Impression
IMPRESSION:
1.Heterogeneous myometrium as described above, including immediately
adjacent to the endometrium
POSITIVE ALERT
The results of this study have been annotated as abnormal in EPIC,
the patient's Group Health electronic medical record.
I am a 44 year old woman, had breast cancer that was ER Positive. Had Bilateral mastectomy. Not doing tomoxifin. My DR. is pushing for Mirena IUD for symptoms below, which is NOT recommended by company for woman that have had breast cancer. Can you talk a look?
Narrative
[HST]: perimenopausal DUB
[SAS]: bleeding after intercourse.
Pelvic Ultrasound.
Transabdominal and Transvaginal exam.
Transabdominal pelvic ultrasound:
The uterus measures 97 x 42 x 64 mm in length, AP diameter, and
transverse diameter respectively. The endometrium and ovaries were
inadequately visualized by transabdominal scanning. Inadequate
myometrial detail as well. We proceeded with transvaginal scanning
therefore in order to better visualize the endometrium and ovaries
and myometrium.
Transvaginal pelvic ultrasound:
The endometrium appears homogeneous and measures 7 mm in AP diameter.
There is a small circumscribed focal echogenicity adjacent to the
anterior margin of the endometrium measuring about 8 x 6 x 7 mm in
diameter. Most submucosal fibroids would be hypoechoic. It is
appearing to be located adjacent to rather than within the
endometrium mitigating against a polyp which would be more commonly
echogenic such as this. Another potential consideration could be
heterogeneous myometrium such as could be seen with adenomyosis.
Other parts of the myometrium also appears heterogeneously echogenic.
( Clinical situation could help determine if MRI of the uterus
evaluate further for possible adenomyosis is desired).Changes from
surgery remains a consideration as well. It was not demonstrated on
the prior ultrasound from 10/21
The right ovary measures 21 x 16 x 27 mm in diameter.
No right adnexal masses or abnormal fluid collections are seen.
The left ovary measures 29 x 18 x 36 mm in diameter
no left adnexal masses or abnormal fluid collections are seen other
than a presumed follicle measuring about 2 cm in diameter.
no abnormalities are identified elsewhere
Impression
IMPRESSION:
1.Heterogeneous myometrium as described above, including immediately
adjacent to the endometrium
POSITIVE ALERT
The results of this study have been annotated as abnormal in EPIC,
the patient's Group Health electronic medical record.
Hello XXXXXXX
First i'd like you to note that there are no studies that state that MIRENA may be risk factor for any type of cancer.Having said that,since you have had a mastectomy, its usually advised to you avoid any hormone therapy.MIRENA is not estrogen based which is a risk factor for breast cancer.It contains progestins.That being a hormone, most specialists advise to avoid hormone therapy in a history of breast cancer.
Mirena is indicated in adenomyosis,dub and also small fibroids. But although the dose of the progestin is small and released in fixed dose,its recommended that its avoided in breast cancer. Given your history of cancer,i would recommend that a D/C and biopsy be done first and a hysterectomy is necessary.
First i'd like you to note that there are no studies that state that MIRENA may be risk factor for any type of cancer.Having said that,since you have had a mastectomy, its usually advised to you avoid any hormone therapy.MIRENA is not estrogen based which is a risk factor for breast cancer.It contains progestins.That being a hormone, most specialists advise to avoid hormone therapy in a history of breast cancer.
Mirena is indicated in adenomyosis,dub and also small fibroids. But although the dose of the progestin is small and released in fixed dose,its recommended that its avoided in breast cancer. Given your history of cancer,i would recommend that a D/C and biopsy be done first and a hysterectomy is necessary.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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