Tamoxifen Plus Removing Ovaries Improves Survival for Premenopausal Women

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A study showed that premenopausal women who had their ovaries removed (called oophorectomy) and took tamoxifen, a hormonal therapy, for 5 years after breast cancer surgery had a lower risk of the breast cancer coming back and better survival rates compared to premenopausal women who didn't have their ovaries removed and take tamoxifen after breast cancer surgery.

Cancers that were estrogen-receptor-positive responded the best to the ovary removal and tamoxifen.

The women in this study were from Vietnam and China, where more premenopausal women are diagnosed with breast cancer than in the United States. The women in the study were diagnosed early, so surgery was an effective treatment. Removing the ovaries of women diagnosed with operable breast cancer is considered an aggressive step.

The ovaries of premenopausal women produce estrogen. Estrogen can encourage breast cancer growth and increase the risk of the cancer progressing or coming back. This is why doctors want to stop the ovaries from producing estrogen as part of the overall breast cancer treatment plan in many premenopausal women.

Removing the ovaries is one way to permanently stop the ovaries from producing estrogen. Medicines also can be used to temporarily stop the ovaries from making estrogen (called medical shutdown). The medicines include Zoladex (chemical name: goserelin) and Lupron (chemical name: leuprolide).

For many premenopausal women, medical shutdown can be a good treatment option. Women who want to have children after breast cancer treatment may prefer this option over ovary removal.

Still, removing the ovaries may be a better option for some women when the risk of the cancer coming back or progressing is high. Other women may choose to have their ovaries removed because they're concerned about their risk of ovarian cancer. Having breast cancer increases ovarian cancer risk, especially in women who have a breast cancer gene abnormality.

If you're a premenopausal woman, removing your ovaries as part of breast cancer treatment is an aggressive step and may be able to lower your risk of the cancer coming back and increase your survival. Still, it also means that you will be permanently in menopause. Talk to your doctor about whether this type of aggressive treatment makes sense for you. Together, you and your doctor can weigh the side effects against the protective effects and decided on a treatment approach that is right for YOU and your unique situation.

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