NCCN Guidelines for Patients
Breast Cancer - Carcinoma in Situ
, Version 1.2016
is not the same as hormone replacement therapy.
Not all women at risk for breast cancer should take
endocrine therapy. Your doctor can let you know if
endocrine therapy is right for you.
Which medicine is used sometimes differs between
women who have menstrual periods and those who
don’t. Tamoxifen is advised for women who have
menstrual periods (pre-menopausal). Tamoxifen
blocks hormones so the growth of cancer cells isn’t
triggered. Tamoxifen and similar medicines may also
be given to women without menstrual periods (post-
menopausal). In addition, post-menopausal women
may be given medicines called aromatase inhibitors.
These medicines lower the amount of female
hormones in your body.
Although endocrine therapy lowers breast cancer risk,
it can cause side effects. Side effects are unplanned
physical or emotional responses to treatment. Side
effects vary between medicines. Some side effects
of endocrine therapy are hot flashes, cataracts, leg
cramps, joint pain, blood clots, and other cancers.
Ask your treatment team for a complete list of side
effects. Your doctor may also know about research
of endocrine therapy or other medicines that you can
If you start endocrine therapy, you will have follow-up
visits with your doctor. Tell your doctor about any side
effects from endocrine therapy. There may be ways
to get relief. Depending on which medicine you’re
taking, you may need to get GYN (
exams, vision tests, and bone density tests.
A third risk-reduction treatment is surgery. Surgery
is mostly done among women at high risk for breast
cancer. If you choose surgery, a bilateral total
mastectomy is advised. This surgery completely
removes both breasts but no lymph nodes and chest
Following the mastectomy, or in some cases at the
same time as the mastectomy, you may want to have
breast reconstruction. Breast reconstruction is a
surgery that inserts breast implants or uses your body
tissue to make a more normal-looking breast mound.
Breast reconstruction is described in more detail in
Your doctor may suggest that you have a bilateral
salpingo-oophorectomy. This surgery removes both
ovaries and both fallopian tubes. It is only advised if
you have or very likely have mutations in the