TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!
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Bird, thank you, I am really hoping for a great outcome. Its been a fight to get to this stage. But others have done it before me so I know its possible. My new surgeon is Dr. Vincent Perrotta in Salisbury, MD.
Macbo4, lots of great info and sources on the Progesterone! My stepfather put me on the bioidentical cream prior to my bc dx after determining I was in mp. My uterus was removed in 2001 due to adenomyosis so I had to kind of guess when I was in mp as I retained my ovaries. He told me progesterone is good for many things but I didn't get all the detail you have provided. Of interest to me is the blood sugar and thyroid support. I also noticed you put "improving libido" on the list more than once *wink*. I am thinking I will ask my NP gyno about the oral bioidentical progesterone. I don't want to be discussing my libido with my stepdad!
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Shoregirl, that made me laugh saying you didn't want to talk to your stepdad about your libido. I didn't realize that I had duplicated the libido one. Actually I want to add that Progesterone helps with Hair Loss as well. My hair started thinning at the front when I was first poisoned, pushed into menopause. The tamoxifen finished the neutering process. I hated feeling like I was going bald on top of everything else, the mutilation, ect. When I started on the Bioidentical Progesterone I saw new hair, like baby hairs start growing in. My hair is closer to my norm then it was. Thank God for Bioidentical Progesterone!
https://ndnr.com/womens-health/treating-female-pattern-hair-loss/
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rachelcarter, I didnt go all the way back to read posts but I saw your last one. I'm 3 months post exchange. I get what you are saying. Even though TEs were hard and stuck out more they felt lighter. These do take some getting used to as far as the heaviness goes. Laying on my back they feel like heavy blobs. I try to sleep without a bra but it's just not as comfortable. I also had a fair amount of pocket revision on one side. Definitely a difference. It just takes a little time. Hope you are feeling ok!
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Macb04, hair loss/thinning yes! Another bane of my 50s!! I say this only being silly...I realize it is a privilege to grow old as so many don't get to. But my hairdresser actually pointed it out to me before I even realized I was a little light on top 2 yrs ago, just before my dx. Mine is probably due to low thyroid and MTHFR. Super thin along the front hairline and in front of ears. It's getting better since I stopped commercial dye and went to henna and sulfate & silicone free hair care products, but I still notice it. I don't think the topical progesterone is enough. Thanks for mentioning this!
DebAl, Rachel...I am almost 12 months out from my exchange and just now feeling like I could live with these implants. The strange peeling of my chest feeling when I get up from lying down is pretty much gone. There are still twinges in one, but I have a problem with either a creased implant or a creased pocket that will be addressed Dec 4th. I knew 1 month after exchange last year I would be going back for revision for several reasons. But you are very early in the healing in the grand scheme of things. Unless there are obvious reasons to consider revising I would recommend giving it at least 8 months to settle. I was not prepared for how long it takes to start being comfortable with implants! Feel better soon!
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I have had both under the pectoral and now, over the pectoral muscle implant. HATED the under pec implant! After I eventually had to have the lat flap surgery, the pectoral was relocated back to its original place, under the boob(or foob , I guess,fake boob) So much better esp if you work out with weights. The relocated latissimus muscle does sometimes forget it's in front now, weirdly contracting when I'm using certain machines at the gym, but I'm getting used to it! About the progesterone cream, I used bioidentical estrogen, progesterone and testosterone creams, pre breast cancer diagnosis. Never felt better! But my Doctors took me off them!😔. I'm er, pr positive. Going to have to ask about Progesterone again, I always believed it was protective against BC. About hair loss, see the hair loss solved post I wrote! Worked for me. I'll show you before and after pics!pm me
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I'm on my second month of Tamoxifen with no SEs so far but if needed down the road I'm wondering if these creams might counter the Tamoxifen's effectiveness.
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I know you can't use Estrace, a vaginal estrogen cream, with tamoxifen . My Dr switched me to anastrazole so I could use it for dryness and pain. But I don't know about Progesterone.
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This diagram, prettier way to show that Real, Bioidentical Progesterone is good for us, better than I can say it., heck it used to be used for bc treatment prior to AI/tamoxifen
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A Role for Progesterone in Breast Cancer Treatment?
June 20, 2017By Lisa DeFerrariin Research ProgressTags: Cancer Clinical Trials, Hormone Receptor-Positive Breast Cancer, Tamoxifen, Targeted Therapies3 Comments
Back in August 2015, I wrote about an article in the journal Nature on some interesting new discoveries about the role of the hormone progesterone in hormone receptor-positive breast cancer.The research suggested that adding progesterone to standard treatment with tamoxifen or an aromatase inhibitor could increase the effectiveness of treatment for this subtype of breast cancer, while possibly also lowering toxicity.
Cancer Research UK reports that these findings are now going to be investigated in three clinical trials that are set to begin.
In addition to possibly increasing the effectiveness of existing anti-estrogen therapies, and maybe also lowering toxicity, another benefit of this potential treatment approach is that it involves existing drugs that are already well understood and widely used–and whose cost is low.
It's encouraging to see these studies going forward. I'll be following developments in these trials with interest. In the meantime, I'm attaching below my earlier post, which includes some background on the role of the progesterone receptor and what the researchers found.
Hormone Receptor Positive Breast Cancer: A Look At New Research Findings
About two out of three women diagnosed with breast cancer have the sub-type that is referred to as hormone receptor-positive breast cancer. This means that when tumor cells (from a biopsy or surgery) are examined under a microscope they're found to have receptors for the hormone estrogen (they are "ER-positive") and/or the hormone progesterone (they are "PR-positive).
The prognosis generally tends to be somewhat better for this type of breast cancer, and there are several targeted hormonal therapies available. These treatment options, which include tamoxifen and aromatase inhibitors, focus on the sensitivity of this type of breast cancer to the hormone estrogen. These drugs work in slightly different ways, but the goal is to "starve" tumor cells of the estrogen they need to survive and grow.
For hormone-positive metastatic breast cancer as well, there are a number of hormonal therapies available. These include tamoxifen and aromatase inhibitors and several newer drugs. All of these treatments work by interfering with the ability of estrogen to fuel the growth of breast cancer cells.
But there are no therapies widely used today that target progesterone or its receptor in either early stage or metastatic breast cancer. Why do we even measure this characteristic at all if it doesn't have any role in determining treatment?
Role of the Progesterone Receptor
Delving into this question a little, I found that the role of the progesterone receptor in hormone-positive breast cancer has been somewhat controversial. The information about PR status has mostly been used to help determine prognosis. That is, a higher level of PR positivity (a numerical level is assigned) has been associated with a somewhat better outcome. And a lower PR level or lack of PR receptors ("PR-negative" breast cancer) is generally not as good a prognosis.
Beyond this role in determining prognosis though, there is disagreement. Some believe that PR status has no role in determining treatment, and that there really is no need to continue measuring it. However, others are of the view that PR status is useful as a biomarker to help identify patients whose ER-positive breast cancer is most likely to respond to specific types of anti-estrogen treatments and to help in choosing the most beneficial treatments for these patients.
Progesterone Receptor Study
In this new study, researchers set out to learn more about how the progesterone receptor actually works. Conducting experiments in cell lines (human breast cancer cells grown in the lab), the researchers found that there is "cross-talk" between the progesterone receptors and the estrogen receptors on breast cancer cells. In other words, they found that the receptors are communicating with each other.
And what was really interesting was that the more of this communication that was going on the better–this was because signals from the progesterone receptor served to tone down the pro-cancer activity of the estrogen receptor.
In another set of experiments, the researchers implanted hormone-positive human breast cancer tumors into mice. They found that exposing the mice to estrogen caused the tumors to grow, while exposing the mice to both estrogen and progesterone actually caused the tumors to shrink. They also found that treatment that included the hormone progesterone, in addition to anti-estrogen therapy (tamoxifen), was more effective than just tamoxifen in reducing the size of the tumors.
What These Findings Could Mean For Patients
These findings will of course need to be confirmed in additional studies including clinical trials. And the possible side effects of combining the hormonal treatments would have to be evaluated.
Hopefully, that follow-up will happen.
The lead researcher on the study, quoted in Medical News Today said the findings provide "a strong case for a clinical trial to investigate the potential benefit of adding progesterone to drugs that target the estrogen receptor, which could improve treatment for the majority of hormone-driven breast cancers."
An interesting aspect of this approach is that it would use an existing drug that is currently available as a generic.
Finally, when talking about progesterone, there's an important distinction to be aware of. The Nature article points out that there's compelling evidence that including progesterone as part of hormone replacement therapy (HRT) increases the risk of breast cancer. However, the authors say the increased risk is mostly attributed to the synthetic form of progesterone that's used in HRT. That increased risk, they said, is not significant when natural progesterone is used.
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3 responses
thesmallc says:June 20, 2017 at 10:43 amThank you for this information. I have always had a curiosity about how progesterone contributes to BC. I had very high level of progesterone (87%) and estrogen (99%) on my pathology report. But now they are saying progesterone may actually be helpful? This is all interesting and I look forward to knowing what researchers find out.
Lisa DeFerrari says:June 23, 2017 at 9:31 amHi, Rebeca. I'm very interested too in seeing what they find out. I always wondered what the purpose was in measuring the level of the progesterone receptor because it didn't seem like a whole lot was done with that information. Perhaps some new insights will come out of this that will be valuable for patients. Thanks as always for reading and for your comments!
Eileen says:June 29, 2017 at 3:10 amAlmost seems counter intuitive. Fascinating though. Who knew?
Welcome! I'm a cancer research advocate who was diagnosed with breast cancer in 1993 at the age of 35. I'm a graduate of the National Breast Cancer Coalition's Project LEAD program, which trains advocates in the fundamentals of breast cancer science. I've also served on numerous panels reviewing cancer research proposals for government funding. Please join us as we follow the progress that's being made in cancer research, care and prevention.
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I would like to a doctor who performs the prepectoral breast implant reconstruction
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hi there question for people? I had bilateral mastectomy August 2017 with immediate reconstruction and tissue expanders UNDER THE PECTORAL MUSCLES.. it was AWFUL, I literally could not take a deep breath or even talk without excruciating pain. So I looked forward to having the swap with the implants on November of 2017. I continue to have excruciating pain and So I found a specialist and had the implant put on top of my pec muscle on January 10th 2018. It's 10 months later and I'm still having terrible pec muscle spasm pain and the tightness on my chest. It's affecting my everyday life even more because now I'm having terrible middle back pain from all of this. What I'm wondering is anyone out there had the BOTOX to QUIET the nerves for the PEC muscles? I've been doing physical therapy and myofascial release and acupuncture for over a year now and nothing seems to help. I am desperate for help and at the end of my rope. There's no way I could live like this for another year let alone even a few more months. I would love to go flat but the emotional struggle with that is really scary to me. PLEASE HELP ANYONE!!!
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hi there question for people? I had bilateral mastectomy August 2017 with immediate reconstruction and tissue expanders UNDER THE PECTORAL MUSCLES.. it was AWFUL, I literally could not take a deep breath or even talk without excruciating pain. So I looked forward to having the swap with the implants on November of 2017. I continue to have excruciating pain and So I found a specialist and had the implant put on top of my pec muscle on January 10th 2018. It's 10 months later and I'm still having terrible pec muscle spasm pain and the tightness on my chest. It's affecting my everyday life even more because now I'm having terrible middle back pain from all of this. What I'm wondering is anyone out there had the BOTOX to QUIET the nerves for the PEC muscles? I've been doing physical therapy and myofascial release and acupuncture for over a year now and nothing seems to help. I am desperate for help and at the end of my rope. There's no way I could live like this for another year let alone even a few more months. I would love to go flat but the emotional struggle with that is really scary to me. PLEASE HELP ANYONE!!!
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Hi Meeshelle, I sent you a PM with some info on things you may already know about for pain.
I hope something is helpful for you soon.
Macb04
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Not Very Brave, how large are your implants?
Macb, do you know how the pectoral muscle is repaired? Also, why didn't go with DIEP?
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Meeshelle, did you listen to this podcast from this website?
https://www.breastcancer.org/community/podcasts/postmastectomy-pain-20181005
This physician has had very positive results with botox, but sounds like he usually tries an injection of a combination of a steroid and long acting local anaesthetic first.
But before that, he starts his patients on an oral medication used specifically for nerve pain, such as gabapentin or lyrica. Have you tried either? I'm MUCH more comfortable while taking gabapentin.
So sorry you are suffering. Hopefully someone on this site has had experience with botox. Have you checked out the thread on Post Mastectomy Pain Syndrome?Here's that link... https://community.breastcancer.org/forum/136/topics/747016?page=57#idx_1687
Becky
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Bird - My implants are 355cc and 395cc. They are Mentor MemoryShape, medium height and moderate profile.
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bird-of-Light, my Pectoral muscle was just arranged in the proper location after the TE was removed. Wasn't sutured in place, weird PS, not sure why he didn't suture. He said he didn't.Despite that, my Pectoral Muscle recovered about 95 plus percent of what it was before the whole mess. I
I was initially going for DIEP and changed my mind because I didn't want such an extensive surgery and long recovery. I especially didn't want such enormous scars.
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There is interesting research being done on Progesterone as a treatment for breast c.
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Hey all of you Ladies,, please spread the word about the safety and efficacy of Bioidentical Progesterone, a grassroots campaign for much needed improvement in QOL
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The list is now up to over 60 Plastic Surgeon's who do Prepectoral Implant Reconstruction in the US.
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I just added Arash Momeni MD to the list. He's at Stanford and has done >100 prepecs.
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Please add Dr. Timothy Schaefer to the Midwest list. He is based out of Edina, MN. Thank hou
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Macb04 - where do you get your bioidentical progesterone and is there a specific brand/manufacturer you'd found is best (at least for you)? I haven't seen a lot of info about dosage and I think my oncologist will just dismiss my wanting to try it.
- xo
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I take specially Compounded Prescription Progesterone that is prescribed by my Oncology trained Naturopath. I take two 25mg capsules at Bedtime. I thought about using Bioidentical Progesterone in a Topical form, but I also wanted steady dosing and the improved sleep benefits you get with the Oral Progesterone instead of the topical Progesterone cream. I read up on it and talked to my Naturopath, who agreed with my idea.
Topical Progesterone needs to be rotated to different sites each time it is used, and there can be differing rates of absorption depending on where you place the cream. For example, women put the Progesterone cream on their shins, or inner forearms, areas without a lot of fat. I use the Progesterone to prevent overgrowth of my Uterine lining, which can occur with use of vaginal estrogen, which I use for treatment of vaginal atrophy.
Another Progesterone is Micronized Progesterone called Prometrium. Alot of other sites wrongly describe the Artificial Progestins side effect when they are describing side effects of Prometrium. This Canadian site is very informative and accurate.
https://www.cemcor.ca/ask/bewildered-bio-identical-hormones
Bewildered by Bio-Identical Hormones
QUESTION
Are bio-identical hormones safe for treatment in menopause? I have no symptoms but did have a blood clot in my calf years ago when I was first pregnant. I was told then to never take estrogen. Could I safely take bio-identical hormones? I'm asking because I recently saw Suzanne Somers on the Oprah show discussing hormone replacement with bio-identicalhormones. She says they are making her feel great. CBC's "The National" last week said that drug company hormone therapy, too, is now considered safe.
ANSWER
Thank you for your question about bio-identical hormone therapy. Each "side" wants us to believe that hormones are safe and to ignore the questions we should all ask: What do I want to treat? Has this medicine been shown to be an effective treatment for this problem? Is this hormone safe for me?
I agree that it is confusing when a form of estrogen that is called "bio-identical" or "natural" is reported to be safe, but the kind of estrogen in Premarin® pills has been proven to cause heart disease, blood clots and strokes. I also saw Suzanne Somers eating her meter-long row of supplements and applying a dab here and a dab there, of what she calls "bioidentical hormone replacement therapy."
I believe that bio-identical hormones are the ideal kind of hormones to use for any necessary treatment because we know how they are metabolized in our bodies and therefore can predict their actions. When something is different from what our bodies make, it may have unexpected effects. For example, medroxyprogesterone (a cousin of progesterone) when used with estrogen treatment, causes an increase in breast cancer risk (1). However, the bio-identical, natural progesterone (Prometrium®) with estrogen prevents a 29% estrogen-related breast cancer increase (2).
What most of us don't realize is that many official drugs—made by pharmaceutical companies and licensed by the FDA or Canada's Health Protection Branch—are bio-identical. For estrogen (officially called 17-beta estradiol), the list of drugs that are bio-identical include Estrace®, Estragel®, Estradot®, Estraderm®, and Climera®. For progesterone, there is Prometrium® and, in some places, a vaginal gel.
There is another reason for the debate over bio-identical hormones—they are regulated differently in different countries. In the USA, bio-identicalhormones can be obtained without a prescription as a "dietary supplement". In Canada they are considered drugs and must be prescribed by a health care provider. That being said, in both the USA and Canada, most compounding pharmacists are trained and certified by an organization that ensures quality control—purity of the basic hormone preparation, careful measurement of the dose, and excellent reliability of the finished medicine.
This is the other important issue that was ignored in the Suzanne Somers episode—any hormones, bio-identical or not, should be used with care. They are not like skin lotion or aspirin. Bio-identical hormones are powerful substances with effects throughout our bodies. We use hormones for a reason. Would you take an antacid if you didn't have heart burn? A pain pill if you have no discomfort? A sleeping pill if you're sleeping well? I don't think so. Menopause is not an illness. It is normal. Low estrogen and progesterone levels are also normal for menopausalwomen. Menopause causes no problems for the majority of menopausalwomen.
However, some menopausal women do need treatment with what I call "Ovarian Hormone Therapy" (OHT, progesterone with transdermalestradiol). OHT is needed and scientifically justified in menopausal women for these two reasons:
- Early menopause that occurred before age 40. It is appropriate to continue bio-identical hormones until age 52 (the average age of menopause), then taper and stop estrogen. You can safely continue progesterone if hot flushes persist.
- Osteoporosis in a woman who is newly menopausal who also has intense night sweats chronically disturbing sleep. Here the OHT can be safely continued for five years before a bone loss-stopping medicine, such as a bisphosphonate, is added. Then the estrogencan be tapered and stopped. Again, progesterone should be continued until off the estrogen and may be safely continued if needed for hot flushes
Severe hot flushes/night sweats only need progesterone or medroxyprogesterone (which is as effective as estrogen) (3).
Now to answer your question: it sounds like you do not need any hormone therapy. If you did, suddenly, start having hot flushes, you can use progesterone cream (20 mg twice a day) that has been shown to improve them (4) and won't increase clotting. I believe that a woman with a past blood clot should never take a pill form of estrogen, whether bio-identicalor not, because that will increase her already increased risk for a second blood clot. You should use caution also, and have a very strong reason for taking estrogen as a patch, gel or vaginal form, although these are less likely than pill estrogen to cause blood clots (5).
Back to Oprah and Suzanne—given that menopause is a normal part of every woman's life cycle, and not a disease—I strongly question the use of any hormone therapy, bio-identical or not, in healthy menopausal women. The notion of menopausal hormone "replacement" is just plain wrong.
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Thanks for all that info Macb04!
- xo
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FYI: Tattoos DO make you feel better. I had no idea how much better everything looks and feels. If I'd know I might have pushed for it sooner. My PS office did such a good job!
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Glad I could help, Andraxo. Let me know if you have any other questions.
I agree Rachecarter35, 3D Nipple/areola tattooing make a huge difference. I had mine done by Vinnie Myers.
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macb04 - would you be comfortable sharing the cost of vinnie's tattoos and how long the wait for an appt was?
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Well, I forget exactly, but it was something like 1,000 per breast. The wait was around 6 months. I travelled down to San Diego area to meet up with him. He rented a posh suite in a Resort which is where I had to go. I paid out of pocket, because my insurance wouldn't pay as it wasn't done in a clinic or hospital. Just one more of the endless sea of expenses that depleted my retirement savings, for no safety in the end.
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Insurance is supposed to pay for tattoos. That seems crazy expensive.
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My husbands backwards insurance would only pay for tattoo if done in a hospital or a clinic. I wanted the tattoo by Vinnie, and he only does hospital tattos back East, in Maryland or somewhere. Actually I think most of his tattooing is done in his tattoo studio. I think it was less money at his regular place, more money when he travels with a crew to do tattoos.
I regretted having reconstruction done in Seattle, my husband was an unsupportive turd about me going away for better surgical options out of state. So when it came time for the tattoo, I decided to get the best tatto I could possibly find. I researched tattoos and spoke with people. He has amazing results, took him 15 minutes as he is just so skilled. He tattoed my real right areola/nipple to get a match when he created the 3d nipple and areola complex for my Left reconstructed breast.
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