Mirina Coil and Breast Cancer

I was amazed to see how many people have written in about the Mirina Coil and Breast Cancer.

I had the coil put in in April 05 because of such bad heavy painful periods, this worked wonders for me, my period more or less stopped, no more embarrasing accidents while out and about.

I was diagnosed with bc Feb 08, had lumpectomy March 3 so cant complain about the time I was diagnosed and op, was really glad to get this thing out of my body.
Before I was due to start my rad, the ong advised me to have the coil out as my cancer was hormonal, was happy to get this coil out too as I didn’t want to take any chances of this coming back again once I had treatment. Since having this coil out, my period have come back worse. Had appt to see gyno last week and saw a wonderful lady Dr who said I should maybe think about ablation, she needed a second opinion and another male Dr came to look at the scan and there was me in all my glory, I found him was quite dismissive and rude, said without even looking at me, who said and why did you have the coil taken out, if it was working then that is less dangerous than having an operation? what am I too think, I do not want this contraption put back into my body so have decided against it. Has anyone else had this suggested to them after having bc.

Lin

Hi Lin,

I had a mirina coil when I was 50 again like you due to heavy and very painful periods. At the time I also had an overy removed as it had a very large cyst attached to it. Even so with one overy I still continued to have periods but thankfully they were easy to deal with and not painful. I was diagnosed with BC in June of this year just before my 53rd birthday and I was told I must have the coil removed because I could not take tamoxifen while still fitted with the coil as the BC was hormone receptive. I have since had a period immediately after my first chemo and it was a heavy one but not too painful not sure what will be happending now as it had been suggested the chemo will stop the remaining overy from working (hopefully at my age that is perfectly o.k. and better than dealing with painful periods). What I am interested to learn is there any suggestion that the mirina coil due to the release of progesterone could be an indicator to BC? I haven’t had anything suggested regarding dealing with periods other than they would now probably cease.

Let me know what you think.

Bevy

Hi Mushroom,

I was very interested to read this. I had Mirena Coil fitted in 05 and was diagnosed with BC last week. So far, no one has said anything about this to me, but I have been worrying about it as I had extremely heavy periods. Obviously I don’t want to go back to that, and my BC is hormonal too. I will definetly be asking about this at my next appointment. Would be interesting to hear of others further down the line that had this problem. I hate it when you get these rude doctors - don’t they realise their whole attitude and manner has such a significant consequence on us - kick him where it hurts next time!!!

Love Traceyxxxx

Hi Tracy,

Sorry to hear that you have been diagnosed with bc too, good luck and hope all goes well for you.

Hi bevy52,

Im not realy sure if there is any relation to bc and the Mirina Coil but its was good to read other people experiences who are in the same position as me.

I have further concerns also about Tomoxifen which I have to start taking soon - could this also be related to the Mirina Coil and the chances of further BC if I were to have the coil fitted again, the combination of these tablet and the coil is a bit worrying to say the least. I think there should be more research going on here, what do you think!!

Lin xx

Hi everyone

I asked one of our specialist nurses about this as this is what she said:

“We have no evidence to show that the Mirena coil (hormone releasing
intrauterine device or ‘IUD’) causes breast cancer.
The Mirena coil is a hormone releasing IUD and there has been no active
study done to show whether use of the Mirena coil is safe or unsafe for
women who have had a diagnosis of breast cancer.
We would advise you to speak with your specialist if you have any
further concerns on this issue.”

Hope this helps

Ann

Hi

I have had the Mirina coil since an ectopic pregnancy in 2000. I was dx a month ago with IDC ER++. I saw my oncologist on Monday who told me to start tamoxafen but asked me to get my coil removed IMMEDIATELY. I asked if there was any correlation between the coil and BC, he said no, but as it releases progesterone it should be removed. I have an appointment tomorrow and am dreading having periods again.

Deb

I had a mirena coil fitted last August and was dx with bc in Jan this year… ironically I had asked for the pill but was turned down dur to being 40 and a smoker, didn’t get the pill but got the cancer anyways! The Mirena coil and the implant were both suggested as suitable alternatives… I opted for the coil.

My tomour was er+ but pr- … I hvae discussed the coil issue with surgeon, GP, onocologist, oncology registrars and 3 breast care nurses…ALL of them have said no need to get coil removed, it is localised hormone, very low dose and it preogesteron as opposed to estrogen so there is no link between my coil and my cancer (not sure if this would be the case for pr+ ladies). The oncologist says that I would be more at risk of developing another tumour if I became pregnant than I am from the coil.

This does seem to be one of those bc issues where opinions vary from once person to another… I take the fact that I have had the same answer from all my health care professionals into the equation and have decided to keep my coil for the time being.

The divergence of opinion on this is interesting. I was originally diagnosed with bc in 1987 at the ripe old age of 25 and tried various forms of non hormonal contraceptive until I had a mirena coil fitted in 2004. I checked with the various health professionals at that time re my history of bc and was advised that it was not a problem. I was then diagnosed with a new primary at the end of 2007 and again a completely different group of people have advised that there is absolutely no need to have the coil removed and they said pretty much what lilacblushes says above. So I too still have the coil - not that I am sure that you can still get pregnant while taking tamoxifen - but I’m not taking any chances

Best regards

Barbara.

I was warned by the oncology registrar that it would be very dangerous to get pregnant whilst on tamoxifen - said it could cause severe damage to a fetous and also greatly increase the risk of the cancer returning, so I assume that it must be possible to get pregnant whilst on tamoxifen. Prior to being given the tamoxifen I had to sign a form to confirm that I had been warned and understood the dangers of pregnancy whilst on the drug.

I was also told that once they got my periods stopped it was highly unlikely that I would re-start again when I completed the 5 years of tamoxifen as by that time I would be 45… they made it sound like I would be ancient!

I’ve continued to have periods through tamoxifen and the mirena. I had the mirena fitted after diagnosis with breast cancer, the first one moved so my periods got heavy again, and the string disappeared. So I had to have surgery last year to take the old one out and put a new one in the right place.

Which it is now. I was told it acts only on the uterus and stops build up of the lining thus acting as a contraceptive and reducing bleeding.

Goodbye heavy periods what a boon plus no need to use condoms

Mole

Hi, I had a mirena coil for 7 years before I was diagnosed with breast cancer! About 6 months after my diagnosis I had it removed and underwent investigations for heavy bleeding - the bleeding started as soon as I went on to tamoxifen. Whilst in hospital having the tests - histoscopy? the consultant came to my bed and suggested I had a mirena coil fitted to cope with the heavy bleeds. can you imagine how angry I felt, before I even had a chance to explain to him why I had it removed he was off on his merry way. I became upset and angry and asked the nurse to call him back only to be told he had left for the golf course! Anyway to cut a long story short, my oncologist suggested I went on to zoladex injections instead of the tamoxifen, this meant that my periods would cease, I have been on this for over two years now. My periods have stopped, maybe it’s worth discussing it with your oncologist. And I did complain about the doctor to the staff they sort of shrugged it off, another patient heard it all and was gobsmacked at the lack of concern.

Hi Lilac,

I,m the same age as you and I think a similar DX from what I have read. IDC grade 2, er pos 1 node pos. 6 fec , rads and 5 yrs tamox. DX last May, and hello again we,ve spoken before.

I was on the Pill for 20yrs before DX and was told to stop taking it straight away although they were very vague as to whether the pill had cause my cancer. Obviously trying to avoid any hint of legal action.

No-one would give me the assurance that I couldnt get pregnant on Tam so My OH got the snip. My Onc also said that as would be 45 when finished treatment that periods would be likely to return and would be fertile again.

Isnt it funny that you have been told the opposite. Its very confusing when medical Professional have different opinions.

Lots of love Andrea xx

Very strange that we get told the complete opposite to each other, so confusing.

Hi all,

I was dx May and finished rads today, hooray!!
Early bc, est+ prog+++. Mirena coil in since 04 and renewed last year due to heavy periods. Onc wanted it out but gynea con said for it to stay in to give me protection against side effects of tamoxifen. Very small chance of womb cancer. So onc agreed and it’s staying until I move on to another medication 52, and menopause due soon. No periods since starting tamx.
Good luck.

I had first mirena coil fitted 1999 straight after birth of 2nd child, diagnosed 2005. I am triple + and have been advised by all consultants + GP to keep it in, also told gives added protection against side effects tamoxifem and is local to that area. (+ no condoms are very convenient as like others have said pregnancy on cancer treatments is not good) I was 37 at diagnoses and even though it grew very quick into large 8cm lump once I started getting prodded about by BC, my BS is adamant I had it for years as grade 2.

Debbie

I don’t think I want to have the coil put back in now but reading other people’s stories it seems that Tomoxifan seems to stop periods with some, so im hoping this happens to me. I just hope that I don’t put on any weight I have always stuggled with my weight in the past so this is a bit of a worry too. I started back at the gym 2 weeks ago and building myself up again for the running machine, did 15 mins the other night so if this don’t keep the weight down I don’t know what will.

Lin xxxx

i had mirena coil fitted summer 06 was dx july 07, my results was slightly pr+ had to have coil removed straight away, i had the coil fitted for very heavy periods which started again straight after removal, they didnt stop on tamoxifen if anything got worse. Saw gynae he wouldnt do ablation as he said its not the best thing to do whilst on tam, sugguested complete hysterectomy, (i have completed my family anyway) oncologist advised to have ovarys removed at same time, have now had surgery 4 weeks ago and feel great, im 36 so a bit young for the menopause, but have now been told i can stop tamoxifen,

As people seem to be given different advice about Mirena by different doctors, it’s worth checking the guidance provided by the Royal College of Obstetricians and Gynaecologists (RCOG)

They say that the The UK Medical Eligibility criteria for contraceptive use assesses the use of Mirena (aka LNG-IUS) in women with a past history of breast cancer and no evidence of current disease for the last 5 years as category 3. Which means that theoretical or proven risks usually outweigh the advantages of using the method.

They do not appear to provide any advice on use of Mirena in breast cancer patients primarily for heavy menstrual bleeding rather than contraception.

They note that it is protective against endometrial hyperplasia, especially for tamoxifen users. They confirm that it can be considered if non-hormonal contraception is unacceptable, and state that it may be considered on an individual basis and in consultation with the patients’ breast surgeon.

Tamoxifen can be used as a fertility treatment which explains some doctors’ concern about pregnancy after breast cancer diagnosis. Sometimes it can alleviate heavy menstrual bleeding so an option for anyone considering Mirena for heavy bleeding rather than contraception, and taking Tamoxifen, could be to just take Tamoxifen and see whether it reduces bleeding as well as protecting against breast cancer and only consider Mirena if Tamoxifen doesn’t work on the bleeding.

In Hansard House of Commons written answers October 17th 2007, it is reported that Dawn Primarolo MP was questioned about Mirena. She advised that, as a precautionary measure, Mirena would be contraindicated in women with progesterone dependent cancers and said that product information for health professionals would be updated to reflect this advice.

The question I would ask to any doctor that recommends it for someone who’s had breast cancer is that, since RCOG says that theoretical and proven risks of its use usually outweigh the advantages, what makes that patient an exception to the rule and what is the clinical evidence to support that opinion? It seems to me, following the Hansard report, that no doctor should advocate Mirena for any woman diagnosed with progesterone dependent breast cancer unless he or she can produce clear evidence to demonstrate why the contraindication can safely be ignored. A good doctor will not mind answering questions like this because it helps patients make informed decisions.

As to whether Mirena increases the risk of breast cancer in the general population, Cancer Research’s website says that there is no evidence that Mirena causes hormone dependent cancers and cites a Finnish Study of 17,000 users to support this statement. It is possible to find more detail about this study by searching on the internet where you can find the study report and also a paper by BfArM, part of the German Ministry of Health. BfArM regards the study as flawed and also notes that it was funded by Schering who markets Mirena in Europe and that the study authors conclude that additional, larger studies with a different methodological approach are needed to either confirm or refute their findings.

Curiously Cancer Research UK mentions that the manufacturer of Mirena says that it should not be used after a diagnosis of cervical, uterine and liver cancer, but omits to mention that the manufacturer advises that it should not be used by those who have or have ever been diagnosed wih breast cancer.

At the start of Feb 08, I wrote to NICE (National Institute for Clinical Excellence) to ask them to select Mirena as a topic to produce guidance for use in people who had been diagnosed with breast cancer, on the basis that doctors seem to give conflicting advice to patients and that little seems to be known about the role played by progesterone in development of breast cancer. They are still considering whether to select it as a topic.