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Cancer

Breast cancer survivor with enlarged ovary

05/16/2008

Question:

I had breast cancer in 2005, 1.2 cm lump stage I grade 9 out of 9, lympnode negitive. Had lumpectomy found cancer cells in breast had to have second surgery to get clear margins. Was treated with chemo 8 treatments followed by radiation. Did not menstrate for 1 1/2 years started menstrating again about a year ago (46 yrs old). Asked gyn to screen for ovarian cancer CA125 test normal ultrasound found complex cyst with enlarged ovary. Told to come back in three months, when I went back they said the cyst was gone but ovary still enlarged. I have not menstrated in two months. Gyn told me to come back next year for regular exam? Should I bring this to the attention of my oncologist, should I be concerned? or am I being overly cautious?

Answer:

I would bring this to the attention of your oncologist. I am not sure if the "enlarged" ovary was considered normal or abnormal by ultrasound. It is certainly not abnormal to have menstrual irregularity after chemotherapy in your mid 40s. If you have a strong family history of breast cancer, or if there is ovarian cancer in the family, this would be a little more concerning. There is no major increase in risk of ovarian cancer in women with breast cancer unless there is a genetic component to the cause of the cancer. But you do not sound "overly concerned", as you have not really had an explanation for the "enlarged ovary". It seems reasonable to take this investigation a little further, with a repeat ultrasound in a few months at a minimum, unless the current report is completely reassuring that the ovary is benign.

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Response by:

Paula  Silverman, MD Paula Silverman, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University