Is suppression of ovarian function always necessary in post-surgical breast cancer treatment?

Dr. Ruth O'Regan
Dr. Ruth O'Regan

For young women with certain types of hormone-fueled breast cancer, the best way to address long-term treatment after surgery has been an ongoing concern. Induced menopause is sometimes recommended by oncologists to reduce likelihood of cancer recurrence, but recent studies indicate that some young women with hormone-driven breast cancer can use estrogen blockers to lessen risk of their cancer recurring, but opt against induced menopause. The most effective path depends on each patient's situation.

CURE Magazine - a publication for cancer patients, cancer centers and advocacy groups - reported on a presentation at the 19th Annual Lynn Sage Breast Cancer Symposium by Ruth O'Regan, MD, professor and head, Hematology, Medical Oncology and Palliative Care.

Dr. O'Regan reviewed research for several post-surgical regimens for breast cancer in women under the age of 50. The studies assessed outcomes for pre-menopausal women with estrogen receptor-positive disease who receive tamoxifen alone versus tamoxifen plus measures to suppress ovarian function.

Two trials showed that in women who had not had chemotherapy, the regimens were similar in effectiveness for cancer recurrence, but suppressing estrogen function was linked to a significant increase in side effects including musculoskeletal problems, osteoporosis, insomnia, and hypertension.

For women who had received chemotherapy, however, including ovarian function suppression as part of the post-surgical regiment was correlated with clear improvement in recurrence rates.

"Given the added toxicities (of ovarian function suppression), we need a better way of working out which patients need this approach," said Dr. O'Regan.

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Photo caption: Dr. Ruth O'Regan (right) talks with a patient in this file photo. Credit: Clint Thayer/Department of Medicine