One way to slow the growth of hormone receptor-positive breast cancer in premenopausal women is ovarian suppression. Ovarian suppression uses medical treatments to prevent the ovaries from making estrogen. This stops menstrual periods and lowers hormone levels in the body (similar to a natural menopause), so the tumor cannot get the estrogen it needs to grow.
Ovarian suppression is only an option for premenopausal women. It is not helpful in postmenopausal women because the ovaries do not make much estrogen after menopause.
Ovarian suppression drugs such as leuprolide (Lupron) or goserelin (Zoladex) can temporarily stop the production of estrogen by the ovaries. In most cases, once drug therapy is stopped, the ovaries begin making estrogen again. This helps women avoid early menopause.
To learn more about a specific ovarian suppression drug, visit the National Institutes of Health’s Medline Plus website.
Surgical removal of the ovaries (oophorectomy) is another type of ovarian suppression. This stops the production of estrogen and progesterone (thus, permanently ending menstrual periods), which leads to early menopause.
Learn more about early menopause and how to manage its symptoms.
The benefit of combining ovarian suppression (through drugs or surgery) with standard hormone therapy (tamoxifen and/or aromatase inhibitors) for premenopausal women with hormone receptor-positive breast cancers is under study. In some cases, however, health care providers may recommend this combination.
Standard treatment for premenopausal women with hormone receptor-positive early breast cancer is tamoxifen. Aromatase inhibitors do not usually work in premenopausal women because their ovaries are still producing estrogen. Because ovarian suppression shuts down the ovaries, premenopausal women with hormone receptor-positive breast cancer may take tamoxifen or an aromatase inhibitor when combined with ovarian suppression. Some findings show that an aromatase inhibitor combined with ovarian suppression may reduce breast cancer recurrence better than tamoxifen combined with ovarian suppression [156-157].
Whether ovarian suppression alone reduces recurrence as well as tamoxifen or an aromatase inhibitor is still under study.
Among premenopausal women, some studies have found ovarian suppression drug therapies to be as effective as chemotherapy in treating hormone receptor-positive early breast cancer . However, standard treatment for these breast cancers is tamoxifen, with or without chemotherapy.
Facts for Life: Hormone Therapy
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