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Tamoxifen always necessary ?

Maple leaf
Posted by

My pregnant daughter has breast cancer, estrogen receptor, successful masectomy, cancer and not spread into lymph nodes. She's had her chemotherapy and now the oncologist is talking of Tamoxifen to take after the birth of her 1st child. My daughter is devastated as had hoped to breast feed her baby was also hoping to have another child in a couple of years. Would it be wise to seek second opinion on this? I am grateful for your reply.

Ellen M-Macmillan
Posted by

Hi Maple leaf,

Thanks for getting in touch with us and welcome to our Online Community.

It’s natural to ask questions when someone you love has been diagnosed with cancer. I can’t imagine how you’re feeling just now. Watching your daughter go through surgery and chemotherapy for her breast cancer whilst being pregnant with her first child can’t have been easy.

It’s only natural that the decision to recommend tamoxifen would be upsetting for you both. Doctors are guided by guidelines such as these from NICE when making decisions about treatments for breast cancer. They are based on the best available scientific evidence.

Tamoxifen is recommended as an adjuvant therapy to decrease the chances of a cancer coming back for women who are pre-menopausal and had a hormone sensitive tumour. Your daughter’s multidisciplinary team will try to consider her unique situation and needs when recommending any treatment.

Unfortunately tamoxifen is not recommended when breastfeeding as drugs can be passed to the baby through breast milk. But it doesn’t definitely mean that she won’t be able to have another child in a couple of years. Some doctors would be happy to allow a break after 2 years of taking the drug to allow someone to have a family.

It’s difficult for us as nurses to say whether this would be an option for your daughter. We would suggest that she talks to her team about her concerns. It’s okay to ask about potential benefits of taking tamoxifen and if there would be an option to have a treatment break. Only her doctors could give advice about whether that is something that they would be happy to do based on your daughter’s individual circumstances.

She may want to ask for a second opinion. Some people find this helpful to do. It’s not that they don’t necessarily trust their doctors but sometimes it can help to explore whether there are other options. Checking with another doctor agrees might make her feel more content that the right decision has been made.

If you think it would be helpful to do, we have a very supportive breast cancer group that you can join.

Being pregnant and having breast cancer must have been a traumatic and isolating experience. Breast cancer care have a “Someone like me” support system that your daughter might find helpful to try. They may be able to put her in touch with someone who has had a similar experience if that is something that she thinks would help.

You or your daughter can also give our Support Line a call on 0808-808-0000. We are open 7 days a week 8am till 8pm.

Best wishes and take care.

Ellen-Macmillan Online Digital Nurse Specialist.