One way to slow the growth of hormone receptor-positive breast cancer in premenopausal women is ovarian suppression. Ovarian suppression uses drug therapy or surgery 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 stop the ovaries from making estrogen. 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.
Standard treatment for premenopausal women with hormone receptor-positive breast cancer is tamoxifen. Aromatase inhibitors do not usually work in premenopausal women because their ovaries are still making estrogen. Because ovarian suppression shuts down the ovaries, premenopausal women may take tamoxifen or an aromatase inhibitor when combined with ovarian suppression.
Some younger, premenopausal women at high risk of breast cancer recurrence may benefit from treatment with ovarian suppression plus tamoxifen or an aromatase inhibitor [81-82]. However, this combined treatment has more side effects than the use of tamoxifen or an aromatase inhibitor alone [81-83]. Talk with your provider about whether ovarian suppression should be added to your treatment plan.
Some findings show that ovarian suppression plus an aromatase inhibitor may reduce breast cancer recurrence better than ovarian suppression plus tamoxifen . Whether ovarian suppression alone reduces breast cancer 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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