Tamoxifen after an oophorectomy - is there a consensus on yes or no?

Hello - I was diagnosed age 44 ER +8 HER + 8 no lymph node involvement - had WLE in 2015 rads x25 plus Zoladex 2 years and now into my 4th year of Tamoxifen. Strong family history (maternal Grandmother breast in 40/50s Mother Ovarian in 60s) but BRCA negative.


I have had an array of gynae issues after the Zoladex ended and, long story short, am having a private oophorectomy 5/4. In my mind, I had always assumed this would remove the need for Tamoxifen - but I understand that may not be the case! I have been trying for 6 weeks to get a response from my BC specialist nurse but it’s impossible:-( Whilst I wait for an answer from her, can I ask if others have experienced oophorectomy and what their action was on medication after? 





Hello Coffeetogo,


I can not speak from experience as I have not had my ovaries removed, however one of my relatives did and continued to take Tamoxifen (she actually asked to keep on it for 10 years - she is in her 10th year now).  She did try an  Aromatase Inhibitor instead after ovary removal but decided to stick with the Tamoxifen, especially as she discovered she was osteopenic.  Tamoxifen can be protective of the bones after natural or induced menapause, unlike the destructive effect of aromatase inhibitors.  However, each medication has it advantages and disadvantages.


By having your ovaries removed, you will obviously be removing your main source of oestrogen.  You will also be removing your main source of testosterone production, which after menapause becomes the main source of oestrogen via the action of aromatase.  Hence, it would seem logical that there would be no need for Tamoxifen or other similar meds.  However, to the best of my knowledge, some oestrogens can still be produced in other body tissues such as the liver, adrenal glands, breasts and fat cells.  Hence, you may be advised to continue with anti hormone type treatment, especially as the cancer was ER8 (mine was too!).  If this is the case, it is obviously your decision whether you continue or not.  Hopefully medical staff can help you weigh up your specific risks and benefits of continuing or stopping treatment.


Hope everything works out for you,