Shutting Down Ovaries Improves Breast Cancer Outcomes in Younger Women
For pre-menopausal women who've been diagnosed with early-stage, hormone receptor-positive breast cancer, there’s some encouraging news. Shutting down the ovaries (ovarian suppression) combined with taking tamoxifen reduced the risk of breast cancer coming back (recurrence) by about 20%, according to a study. It also helped the women live longer.
When reviewing the study, Breastcancer.org Medical Adviser Kevin Fox, MD, pointed out that it was a massive undertaking by a well-respected research group and may change the standards of care.
Ovarian suppression stops the ovaries from working, either temporarily, using medication, or permanently, by surgically removing the ovaries. It’s been used to treat hormone receptor-positive breast cancer in younger women for many years. But doctors haven’t been sure how much benefit ovarian suppression adds when combined with other treatments, like tamoxifen and chemotherapy. These results offer a clearer answer.
The study was a meta-analysis, meaning researchers looked at information from 23 earlier studies that involved more than 15,000 pre-menopausal women diagnosed with early-stage hormone receptor-positive breast cancer. While adding ovarian suppression to tamoxifen further reduced recurrence risk among all the participants, women younger than 45 got the most benefits: Their recurrence risk was cut by about 25%, as was their risk of dying from breast cancer.
Ovarian suppression didn’t increase the risk of death from other causes or raise the risk of developing other cancers.
The researchers noted some women who have ovarian suppression and take tamoxifen may have more severe menopausal side effects, like hot flashes and vaginal and urinary issues (called genitourinary syndrome of menopause or GSM). This is because both ovarian suppression and tamoxifen can cause these side effects. But knowing the benefits of ovarian suppression can help women have informed discussions about treatment options with their doctors. Together, they can weigh the risks and benefits and choose what is best for them.