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Review
. 2024 Apr;25(4):523-542.
doi: 10.1007/s11864-024-01190-8. Epub 2024 Mar 13.

Ovarian Suppression: Early Menopause and Late Effects

Chiara Molinelli  1   2 , Flavia Jacobs  3 , Guilherme Nader-Marta  4 , Roberto Borea  1   2 , Graziana Scavone  2 , Silvia Ottonello  2 , Piero Fregatti  5   6 , Cynthia Villarreal-Garza  7 , Jyoti Bajpai  8 , Hee Jeong Kim  9 , Silvia Puglisi  10 , Evandro de Azambuja  4 , Matteo Lambertini  11   12
Affiliations
Review

Ovarian Suppression: Early Menopause and Late Effects

Chiara Molinelli et al. Curr Treat Options Oncol. 2024 Apr.

Abstract

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.

Keywords: Breast cancer; Endocrine treatment; Ovarian suppression; Young patients.

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Conflict of interest statement

Chiara Molinelli reports fees from Novartis and Eli Lilly, travel grants from Gilead and Menarini (all outside the submitted work). Guilherme Nader-Marta reports meeting/travel grants from Roche, Bayer and AstraZeneca (all outside the submitted work). Evandro de Azambuja reports honoraria and/or advisory board from Roche/GNE, Novartis, SeaGen, Zodiac, Libbs, Pierre Fabre, Lilly, Astra-Zeneca, MSD, Gilead Sciences; travel grants from Roche/GNE and Astra-Zeneca; research grant to his institution from Roche/GNE, Astra-Zeneca, and GSK/Novartis, Gilead Sciences (all outside the submitted work). He’s ESMO director of Membership 2023–2024 and BSMO President 2023–2026. Matteo Lambertini reports advisory role for Roche, Lilly, Novartis, Astrazeneca, Pfizer, Seagen, Gilead, MSD and Exact Sciences and speaker honoraria from Roche, Lilly, Gilead, Novartis, Pfizer, Sandoz, Libbs, Daiichi Sankyo, Knight and Takeda, Travel Grants from Gilead, Roche and Daiichi Sankyo, and research support (to the Institution) from Gilead outside the submitted work. The other authors made no disclosures.

Figures

Fig. 1
Fig. 1
Potential side effects of ovarian function suppression. Created with BioRender.com.
See this image and copyright information in PMC

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