Published in:
Open Access
13-03-2024 | Breast Cancer
Ovarian Suppression: Early Menopause and Late Effects
Authors:
Chiara Molinelli, MD, Flavia Jacobs, MD, Guilherme Nader-Marta, MD, Roberto Borea, MD, Graziana Scavone, MSc, Silvia Ottonello, MSc, Piero Fregatti, MD, PhD, Cynthia Villarreal-Garza, MD, PhD, Jyoti Bajpai, MD, Hee Jeong Kim, MD, PhD, Silvia Puglisi, MD, Evandro de Azambuja, MD, PhD, Matteo Lambertini, MD, PhD
Published in:
Current Treatment Options in Oncology
|
Issue 4/2024
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Opinion statement
Around 90% of breast tumours are diagnosed in the early stage, with approximately 70% being hormone receptor-positive. The cornerstone of adjuvant therapy for early-stage hormone receptor-positive breast cancer is endocrine therapy, tailored according to disease stage, biological characteristics of the tumour, patient’s comorbidities, preferences and age. In premenopausal patients with hormone receptor-positive breast cancer, ovarian function suppression is a key component of the adjuvant endocrine treatment in combination with an aromatase inhibitor or tamoxifen. Moreover, it can be used during chemotherapy as a standard strategy for ovarian function preservation in all breast cancer subtypes. In the metastatic setting, ovarian function suppression should be used in all premenopausal patients with hormone receptor-positive breast cancer to achieve a post-menopausal status. Despite its efficacy, ovarian function suppression may lead to several side effects that can have a major negative impact on patients’ quality of life if not properly managed (e.g. hot flashes, depression, cognitive impairment, osteoporosis, sexual dysfunction, weight gain). A deep knowledge of the side effects of ovarian function suppression is necessary for clinicians. A correct counselling in this regard and proactive management should be considered a fundamental part of survivorship care to improve treatment adherence and patients’ quality of life.