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- Title
Estrogen levels in young women with hormone receptor-positive breast cancer on ovarian function suppression therapy.
- Authors
Tesch, Megan E.; Zheng, Yue; Rosenberg, Shoshana M.; Poorvu, Philip D.; Ruddy, Kathryn J.; Tamimi, Rulla; Schapira, Lidia; Peppercorn, Jeffrey; Borges, Virginia; Come, Steven E.; Snow, Craig; Bhasin, Shalender; Partridge, Ann H.
- Abstract
Ovarian function suppression (OFS) benefits young women with hormone receptor (HR)-positive breast cancer but they are at risk for ovarian function breakthrough. We assessed endocrine effects of gonadotropin-releasing hormone agonist (GnRHa) treatment in a prospective cohort of patients aged ≤ 40 years with HR-positive breast cancer. Plasma estradiol (E2), estrone, and follicule-stimulating hormone (FSH) levels were measured from blood samples drawn 1 and 4 years after diagnosis. Patient characteristics, invasive breast cancer-free survival (iBCFS), and overall survival (OS) were compared between those with and without E2 > 2.72 pg/mL during GnRHa treatment. Among eligible patients, 54.7% (46/84) and 60% (15/25) had E2 > 2.72 pg/mL at 1 and 4 years, respectively. Factors associated with E2 > 2.72 pg/mL at 1 year were no prior chemotherapy (P = 0.045) and tamoxifen use (P = 0.009). After a median follow-up of 7 years, among patients with stage I-III breast cancer (N = 74), iBCFS events were seen in 6 (8.1%) with E2 > 2.72 pg/mL and 5 (6.8%) with E2 ≤ 2.72 pg/mL (P = 0.893). Among patients with de novo metastatic breast cancer (N = 12), 6 (50%) with E2 > 2.72 pg/mL and 3 (25%) with E2 ≤ 2.72 pg/mL died during follow-up (P = 0.052). Larger studies exploring the clinical implications of incomplete E2 suppression by GnRHa are needed to ensure optimal OFS treatment strategies are being employed for this population.
- Subjects
METASTATIC breast cancer; GONADOTROPIN releasing hormone; ENDOCRINE glands; HORMONE receptors; BREAST cancer
- Publication
NPJ Breast Cancer, 2024, Vol 10, Issue 1, p1
- ISSN
2374-4677
- Publication type
Article
- DOI
10.1038/s41523-024-00680-0