u/Designer_Hunter_2809

Can anyone point me to some studies showing the safety of vaginal estrogen for women with hormone positive breast cancer?

My oncologist (at an NCI Cancer Center) insist that the data is inconclusive so the policy of the breast oncology team is to not prescribe it. I would like to push her on this and I’m actually considering switching to a lower ranked facility because of it, I also feel like she was a little dismissive of the possible side effects of tamoxifen.

Editing to add that I am pre-menopausal

I am 43 years old and had (what was supposed to be) a prophylactic bilateral mastectomy last month, which found one 2mm tumor in my left breast with clear margins. They have not classified it as IDC or ILC, just invasive mammary carcinoma, but my oncologist suspects ILC because I also had focal atypical lobular hyperplasia in that breast.

I am stage 1a, grade 1, ER/PR+ (95%/76%) HER2-, KI-67 is 4.67%. I have a family history of breast cancer but all genetic testing has come back negative.

My oncologist has given me the option to start tamoxifen, but she says it was optional and totally my choice. They have not run an Oncotype because there’s not enough tissue to do so, so the best estimate of recurrence risk she can give me is 2% with tamoxifen and 4% without.

It seems like the reasonable option would be to try tamoxifen and see how I tolerate it, but I am more worried about the latent risks (especially uterine cancer) then hot flashes or other common side effects that would present themselves more obviously.

My head is spinning, has anyone been in a similar situation and if so what did you decide?