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All TopicsForum: Hormonal Therapy - Before, During and After → Topic: Estrogen levels

Topic: Estrogen levels

Forum: Hormonal Therapy - Before, During and After —

Risks and benefits, side effects, and costs of anti-estrogen medications. Note: Please remember that there are good experiences and bad with ALL treatments and this is a safe place to share YOUR experience, not to be influenced or influence others.

Posted on: Jan 19, 2017 05:02PM

KathyL624 wrote:

Has anyone had their estradiol levels tested? Care to share? Also, wondering if it is possible for post menopausal women who take an AI to have zero estrogen? Or will we always have some

Dx IDC, Left, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Jan 19, 2017 06:47PM dblomom wrote:

KathyL624,

I just logged on to this site for this specific reason! I am trying to educate myself on the estrogen levels that are "normal" after chemo in pre-menopausal women. Although....I doubt there is a "normal" ;-)

Here is why I am wanting to learn more~after a slow and steady climb since August, 2015 in my estradiol level post chemo (Aug 2015 <5pg/mL, Feb 2016-25pg/mL, May 2016-90pg/mL, Sept 2016 335pg/mL), I learned yesterday that the bottom has fallen out. Coincidentally, I told my Oncologist yesterday before she had the results that I felt the best I have mentally/emotionally (my poor husband!) in a very long time. At my last check in September, 2016, it had climbed up to 335 pg/mL but yesterday, it is back down to <5 pg/mL, which was what it was right after I finished chemo.

I am not sure why I am hung up on these #'s, especially given the fact that I feel so much better hormonally. Given that my bc was hormone positive (both estrogen and progesterone), I tend to get a little hung up on that Mother Nature has in store. I should maybe also mention that I have not had a period in 22 months (the only GOOD thing to come out of all of this!), was pre-menopausal at dx and am on Tamoxifen. How about you, have you had yours tested? So glad you inquired about this topic, I hope to learn more.

Amy


Dx 12/31/2014, IDC, Left, 2cm, Stage IIA, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 1/17/2015 Mastectomy: Left, Right Chemotherapy 3/18/2015 Hormonal Therapy 7/9/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jan 19, 2017 07:47PM KathyL624 wrote:

Hi! I just had my levels tested and they were <5. Is this bottomed out? I was 38 at diagnosis, 39 now and doing lupron plus anastazole. I asked my doctor to run the test to make sure the lupron is working. I guess I am just wondering how low it should be on this regimen. Is zero estrogen possible

Dx IDC, Left, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Jan 19, 2017 08:09PM dblomom wrote:

I am not certain that zero estrogen is possible, but I am no medical professional. My reason in saying that is because even if you have your ovaries removed, your adrenal glands still produce some sort of estrogen. I am not sure what kind of level it *should* be however given that my pendulum has swung (what I would call) pretty drastically, <5 might be the lowest level that it can report. All of this is just speculation on my part, based on my own personal experience and what I have discussed with my MO. I hope you find the answers you are needing! ;-)

Dx 12/31/2014, IDC, Left, 2cm, Stage IIA, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 1/17/2015 Mastectomy: Left, Right Chemotherapy 3/18/2015 Hormonal Therapy 7/9/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jan 19, 2017 09:03PM KathyL624 wrote:

Interesting that your levels have swung down again. Were you taking tamoxifen while they were up at premenopausal levels? What exactly are you worried aboyt

Dx IDC, Left, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Jan 20, 2017 05:54AM - edited Mar 24, 2017 03:48PM by obsolete

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Jan 30, 2017 06:03PM Bagsharon wrote:

My MO tested mine on the day of my last chemo infusion to ensure I was menopausal. My Estrodiol was <10, my LH was 36.7 and my FSH was 54.0.

Diagnosed at 52. IDC with Lobular features. N0(+i) in 1 node, LVI, Oncotype 20. Not found on screening mammogram 6 months prior. Dx 7/5/2016, IDC, Right, 2cm, Stage IIA, Grade 2, 0/6 nodes, ER+/PR+, HER2- Surgery 8/1/2016 Lumpectomy; Lymph node removal: Sentinel Chemotherapy 9/6/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 11/27/2016 Whole-breast: Breast Hormonal Therapy 12/30/2016 Arimidex (anastrozole)
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Jan 31, 2017 01:09PM BlueGirlRedState wrote:

Almost 60, and have been menopausal for years. I will most likely be prescribed an Aromatase Inhibitor. Did 4 rounds of TC, bi-lateral mastectomy, even though the surgeon felt that there was no reason to remove the healthy breast along with the one that had the tumor. Estrogen is still produced by adrenal glands. DR says there is no need to measure estrogen prior to taking AI. So how is its effectiveness monitored? Is there a "safe" level of estrogen ? Concerned about side effects of AI, alternatives to AI, and feeling confident that it is doing any good.

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Feb 3, 2017 07:08PM mdoc524 wrote:

Hi All - KathyL I am so glad you posted this. I read an article about how Tamoxifen or Arimidex may not work as well for some women and my MO has never tested my Estrogen level. I was pre-menopausal at dx (Age 45 April 2015) and my period stopped after 2nd AC chemo and never came back. After Chemo & Rads was declared NED in March 2016 and started Tamoxifen. Had my Ovaries out as added insurance in June 2016. I talked to my MO's nurse and MO agreed to send scrip for bloodwork to check estrodial levels. I was concerned because my nurse said the issue will be understanding my levels since I am on Tamoxifen and had my ovaries out .. I know that we can get estrogen from the food we eat and it can be stored in our Fat cells but I would think that they should have some idea what our levels should be ..Anyway will share my levels when I find out.. thanks

Mary

Mary - 47 Year Old Mom of 10 Year old Twins! "Cancer picked the wrong Girl" Dx 4/22/2015, IDC, Left, 3cm, Stage IIB, Grade 1, 2/2 nodes, ER+/PR+, HER2- (IHC) Surgery 5/27/2015 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 5/27/2015 Lymph node removal: Left, Sentinel, Underarm/Axillary Chemotherapy 7/31/2015 AC + T (Taxol) Radiation Therapy 2/1/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 3/29/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 6/6/2016 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 6/6/2016 Prophylactic ovary removal Hormonal Therapy 2/1/2017 Arimidex (anastrozole)
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Feb 3, 2017 08:17PM Denise-G wrote:

I had a period just before chemo started then no more. So when it was time to take an AI, my MO

had my Estradiol levels checked ever 2 weeks for 2 months to make sure I was in menopause. He

said that is one of the hardest levels to check, so sent my blood tests to Mayo Clinic as he said they

do one of the best jobs on this.

After I was on the AI for two years, my side effects start lessening. So he checked my Estradiol

levels again to make sure the drug was working. It was!


www.denise4health.info my BC Blog with over 175 informative posts - stop by and say hello! Myself, my mom, and sister were all diagnosed with BC within 3 years. What a ride! Dx 10/10/2011, IDC, Left, 6cm+, Stage IIIA, Grade 2, 9/14 nodes, ER+/PR+, HER2+ (FISH) Surgery 11/22/2011 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left Chemotherapy 12/26/2011 AC + T (Taxol) Targeted Therapy 2/27/2012 Herceptin (trastuzumab) Hormonal Therapy 10/10/2012 Arimidex (anastrozole)
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Feb 4, 2017 08:58AM dtad wrote:

Hi everyone...IMO most MOs know very little about female hormones. I would love to see a endocrinologist or even a gynecologist on our treatment team. I feel this is a huge gap in our care. Good luck to all navigating this disease.

Dx 3/20/2015, IDC, Left, 1cm, Stage IA, Grade 2, ER+/PR+, HER2- Dx 4/10/2015, ILC, 1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery 5/21/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Feb 9, 2017 08:14PM vlnrph wrote:

My oncologist insisted on two sets of lab values a few months apart before switching me to letrozole.

For clarification: the adrenal glands do not produce estrogen itself when ovarian function ceases. Instead, a similar class of molecules called androgens are changed by the aromatase enzyme into our favorite female hormone (this conversion likes to take place in fat tissue which is why weight control is so important)

In some people, tamoxifen can be metabolized more rapidly than average. This leads to a concern that it might not be around long enough in their system to adequately block receptors. There are tests available commercially to assess this phenomenon but agreement on clinical significance is lacking.

IDC too! Rt MX/DIEP 4-2011; ALND 5-2011 d/t micromets; TC X 4; tamoxifen; lymphedema as of 9-18-11; switch to letrozole 3-15-14; Discovery made during chemo=I'm a human BEING, not a human DOING Dx 3/7/2011, ILC, 2cm, Stage IIA, Grade 2, 1/25 nodes, ER+/PR+, HER2-
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Feb 9, 2017 08:24PM KathyL624 wrote:

I had my MO check my estradiol a few weeks ago and it was less than 5 (less than 10 is considered post menopausal). Makes me feel more confident that lupron is working

Dx IDC, Left, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Feb 10, 2017 05:42PM mdoc524 wrote:

Thanks for sharing .. I went for bloodwork on Tuesday to have Estradiol checked - waiting for results!!

Mary - 47 Year Old Mom of 10 Year old Twins! "Cancer picked the wrong Girl" Dx 4/22/2015, IDC, Left, 3cm, Stage IIB, Grade 1, 2/2 nodes, ER+/PR+, HER2- (IHC) Surgery 5/27/2015 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 5/27/2015 Lymph node removal: Left, Sentinel, Underarm/Axillary Chemotherapy 7/31/2015 AC + T (Taxol) Radiation Therapy 2/1/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 3/29/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 6/6/2016 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 6/6/2016 Prophylactic ovary removal Hormonal Therapy 2/1/2017 Arimidex (anastrozole)
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Feb 12, 2017 11:58AM - edited Mar 24, 2017 03:48PM by obsolete

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Feb 12, 2017 01:31PM - edited Feb 12, 2017 02:17PM by Falconer

WeAreConnected,

Thanks for sharing. I'm only halfway through the talk. And very interested. I'm trying not to feel bad, though, about listening to these two men talk women's issues. Ugh. Just now, the way they said, psychosexual functioning "libido" and dropped their eyes. I had such a strange sense that there is still such awkwardness with what is culturally acceptable for women's sexuality. Until society straightens that out, breast cancer may never see a cure. Anyway I'm going to keep watching and see about your thinking above.

And it was also even evident again in their discussion of male breast cancer and the fact that it's "good" according to these doctors that men don't experience menopause.

to me it looks like the e2 levels are around 40 in post menopausal women and that on an AI it can go to negligible amounts below 10. Is that how you see it? One thing that came through very clearly is that there would be nothing good said about Tamoxifen, "an old actor to usher off the stage." So these doctors would ignore any potential benefits of Tam to push their work with AIs.

One thing I am wondering is what purpose there is to measuringyour estradiol levels?


Strong is the new strong. Dx at 45. Onco 16. Monthly Lupron shots. Dx 7/2016, IDC, Left, 1cm, Stage IB, Grade 2, 0/3 nodes, ER+/PR+, HER2- Dx 7/2016, DCIS, Left, 5cm, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2- Surgery 5/29/2017 Reconstruction (left): DIEP flap Surgery Lymph node removal: Sentinel; Mastectomy: Left Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Aromasin (exemestane)
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Feb 12, 2017 04:30PM - edited Feb 12, 2017 04:32PM by Falconer

sorry weareconnected for my question. Here's an article that goes along with your concern. Perhaps... http://www.cancernetwork.com/breast-cancer/incompl...

"Considering that treatment with a GnRHa plus aromatase inhibitor will be increasingly adopted, knowing whether a patient has suboptimal estrogen suppression in real time will become clinically important."

But I guess what I am wondering is what to do? Go off of Lupron and AI if estradiol levels are too high? And switch to Tam?I haven't found a report that said so.

Strong is the new strong. Dx at 45. Onco 16. Monthly Lupron shots. Dx 7/2016, IDC, Left, 1cm, Stage IB, Grade 2, 0/3 nodes, ER+/PR+, HER2- Dx 7/2016, DCIS, Left, 5cm, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2- Surgery 5/29/2017 Reconstruction (left): DIEP flap Surgery Lymph node removal: Sentinel; Mastectomy: Left Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Aromasin (exemestane)
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Feb 12, 2017 07:07PM mdoc524 wrote:

Very Interesting Video.. I have been on Tamoxifen now for 10 months & waiting on Estrodial results .. I had my ovaries removed last June so it sounds like I might be better off switching from Tamoxifen to an AI. My MO said last year my plan would be 2-3 years on Tamoxifen then 7-8 years on an AI ... I might push for the AI now

Mary - 47 Year Old Mom of 10 Year old Twins! "Cancer picked the wrong Girl" Dx 4/22/2015, IDC, Left, 3cm, Stage IIB, Grade 1, 2/2 nodes, ER+/PR+, HER2- (IHC) Surgery 5/27/2015 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 5/27/2015 Lymph node removal: Left, Sentinel, Underarm/Axillary Chemotherapy 7/31/2015 AC + T (Taxol) Radiation Therapy 2/1/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 3/29/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 6/6/2016 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 6/6/2016 Prophylactic ovary removal Hormonal Therapy 2/1/2017 Arimidex (anastrozole)
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Feb 13, 2017 07:23AM - edited Mar 19, 2017 07:26PM by obsolete

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Feb 13, 2017 09:04AM Falconer wrote:


WeAreConnected:

http://ascopubs.org/doi/pdf/10.1200/JCO.2015.62.37...

This is the longer article I was looking for that I had read- the other link I posted looks like a summary of the findings in this article. I'm sitting in the MOs office as I write this. About to have Lupron #4 and receive my script for Aromasin. Happy Valentines Day! Bye bye estrogen... My MO already said if the AI is too much, he will switch me to Tam. Hope you're feeling well today

Strong is the new strong. Dx at 45. Onco 16. Monthly Lupron shots. Dx 7/2016, IDC, Left, 1cm, Stage IB, Grade 2, 0/3 nodes, ER+/PR+, HER2- Dx 7/2016, DCIS, Left, 5cm, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2- Surgery 5/29/2017 Reconstruction (left): DIEP flap Surgery Lymph node removal: Sentinel; Mastectomy: Left Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Aromasin (exemestane)
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Feb 15, 2017 04:11PM - edited Mar 24, 2017 04:08PM by obsolete

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Feb 15, 2017 05:57PM - edited Feb 15, 2017 06:30PM by Falconer

WeAreConnected:

Thanks for sharing the info about Estradiol testing thru Mayo Clinic.

Here is a recent publication. Perhaps you already shared it on this site somewhere. I can't remember where I found the link:

Is Estradiol Monitoring Necessary in Women

Receiving Ovarian Suppression for Breast Cancer?

"Tamoxifen has for decades been the cornerstone for management of early and metastatic breast cancer for both pre- and postmenopausal women. Treatment with adjuvant AIs for 5 years reduces relative 10-year breast cancer mortality rates by approximately 15% compared with tamoxifen in postmenopausal women.There- fore, an AI should be the preferred option for postmenopausal patients, whereas the optimal adjuvant endocrine treatment of pre- menopausal women is still controversial.3 OFS with gonadotropin- releasing hormone agonists (GnRHa) in combination with AIs became an appealing approach to further improve survival in premenopausal women, as demonstrated for the postmenopausal group. "

http://ascopubs.org/doi/pdf/10.1200/JCO.2015.65.34...

Strong is the new strong. Dx at 45. Onco 16. Monthly Lupron shots. Dx 7/2016, IDC, Left, 1cm, Stage IB, Grade 2, 0/3 nodes, ER+/PR+, HER2- Dx 7/2016, DCIS, Left, 5cm, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2- Surgery 5/29/2017 Reconstruction (left): DIEP flap Surgery Lymph node removal: Sentinel; Mastectomy: Left Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Aromasin (exemestane)

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