Post Menopause Question

I was reading a website
http://my.webmd.com/content/article/51/40639? src=Inktomi&condition=Menopause

on Post Menopause to try understand what really makes a woman considered to be "post menopause" and it stated something which really confused me. (I get confused easily, these days.<g) The article stated that when a woman is post menopause she has a lower level of estrogen in her body and is at a "higher" risk for "breast cancer". Now this is what confuses me. I thought a lower level of estrogen protects me from bc since I am ER+.
So why do they state it can give one bc?

I was under the impression that I am going to be put on that Arimidex stuff to stop the estrogen in my body from causing more cancer. I had no idea we still produce estrogen after menopause. Is this the estrogen which comes from our adrenal glands or some place like that? Also if I am still producing estrogen, can I truly be considered "post menopause"?
Is the main factor considered by the stopping of our periods?

I know I may not be stating this too clearly but what I am trying to make certain of is that I truly AM "post menopause" so that my Onc will give me the right pills after radiation is done. For months he said it would be Tamoxifen and suddenly when I asked him if he saw in my report I was Her2+ and ER+, he changed gears and said the drug must be
Arimidex now. Look....personally he is a very sweet, kind, nice doctor but talking to him is like talking to the wall. I can't seem to get the clear concise answers from him that I can even get from you folks. I am not stupid but there is a lot of bc stuff I don't understand and want to learn.

I know.....if I don't have confidence in my Onc I should find one I can have confidence in. Not to start any more poster wars but when a certain poster on here states her concerns about finding good doctors.......they are not that easy to find when your medical insurance only gives you a few and you don't know them from beans. So will you nice, knowledgeable folks see if you can give me some answers on the post menopause and estrogen questions. If you get to be a certain elderly age goes that put a woman in the class for certain?

Thanks once again for any answers you may have and are willing to share with me.

I've been post-menopausal for about 14 yrs or so, and it's my understanding that the body still has some estrogen, but not from the ovaries. Also, I believe that the amount of fat one has contributes to the level of estrogen. But mainly, I wanted to agree with you about oncologists and the lack of real information that they seem to relate to their patients. The onc I'm going to now is 72 yrs. old and is very well thought of for his clinical abilities, but he is definitely from the era when the doctor gave the orders and the patient obeyed without question.
He offers no information, seems to ignore or brush off quetions, and basically tells me nothing. If I hadn't gone around getting copies of the reports of my tests/scans in Sept. I would not have even known that
I had pleural effusion and partial collaspe of my lung. He made no mention of it. I consequentially got better and he listens to my lungs and say they sound clear. It was also found at that time, that I had a blood disorder which needed treatment before anything else.

I'm not one that wants a lot of pills or less-than-necessary treatments, but I certainly would like some informative conversation about a life-threatening disease. But, Noooooo, I learn most everything from internet support groups and some very knowledgable people who have life experiences. But I guess this is a different topic than your original question. Still, it triggered my "hot" button.

I should also say that I've come to have great respect for the thoughts and practical knowledge that many people outside the medical profession share. By now I listen to docs with a somewhat skepical ear.

no idea we still produce estrogen after menopause. Is this the estrogen which comes from our adrenal glands or some place like that? >>

Hi Bea, I don't know or can't recall the answers to all of your questions, but my understanding is that the adrenal glands can turn aromatase into estrogen. (I think that's the way it works). Estrogen can also come from body fat as well. However, once the ovaries stop producing estrogen, one is considered menopausal.
Bea, the difficulties you report when talking to your oncologist are not uncommon. Treatment of cancer is NOT an exact science, unfortunately. In addition new information and new recommendations are coming out all the time.
I was quite naive when I was dx'd. As far as breast cancer is concerned I thought one either had it or didn't. I had no idea there were different kinds, let alone so many variations amongst each. I had no clue what ER +/- meant. I didn't even know the signifiicance of positive nodes (which was probably a good thing or I might have been quite depressed--my pathology report was 'bad'

more positive edge).
I have spent much of the past 33 months learning as much as I could about breast cancer and its treatment. I receive my primary treatment through a non-profit HMO. Although I know I could get an outside second opinion at their expense we have done it on our own. It has not been easy but it became a priority for us.
One thing I've learned is that by increasing my knowledge about what breast cancer is about--and so much still is not known--in fact more may not be known than is known--I have been able to make better informed decisions. It is very difficult and feels very insecure when one is asked to make major life decisions regarding treatment when you have no knowledge or understanding about what is going on. Knowledge IS power. At the same time, most oncologists treat different types of cancer patients. New research is being published regularly in all areas of cancer. I subscribe to one web site which lists the journals accepted for publication each week on breast cancer alone. The numbers range from about 50 to 100 new articles each week--again for breast cancer only. I have no idea how many articles come out re. other cancers. It is almost impossible for an oncologist to keep up to date on everything--there is no time to do that and treat patients, unless of courxe, they have NO life outside of their profession (and event then it is not possible). There is just too much.
In addition, publication of most recent research findings has resulted in recommendation changes regarding treatment. Previously, Tamoxifen was the first choice of hormonal treatment recommended for ER+ women who did not have metastatic disease. That recommendation has somewhat changed. In addition, not all ER+ women respond the same to any given treatment.
Cancer is not like a routine bacterial infection--where one gets a standard treatment which usually 'cures' what is going on at that time. A cancer cell is a mutated cell. It responds somewhat like a fetus in the way our body learns to tolerate it. Chemo is given with the intention of eliminating it or them. Sometimes that works completely. Other times it works partially or not at all. There is no way to tell. In addition, the cancer cells within us may continue to mutate. What works on some may not work on all. What worked previously may not work in the future.
Cancer is now being looked at a disease which may not have a cure but CAN be managed long-term (such as diabetes). HOpefully, someday there WILL be a cure but they (researchers) are not there yet.

Ok folks, make up your minds! My doctor being confused is one thing but
I can't have "you" confused about what drug I should take. You must know I am NOT touching any drug unless I feel confident "you" feel it is right for me. So I am taking it that you both agree I should try the
Arimidex and I agree I "think" I am post menopause.

Happy New Year 2004 and thanks for all the help in 2003!