Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Norton Cancer Institute, Louisville, KY, USA.
Curr Oncol Rep. 2024 May;26(5):427-438. doi: 10.1007/s11912-023-01491-5. Epub 2024 Jan 2.
Pre-menopausal women diagnosed with hormone receptor (HR) breast cancer are candidates for prolonged hypoestrogenism to improve cancer outcomes. However, the disease benefit eclipses the toxicities associated with ovarian function suppression (OFS), which are often under-reported.
Increased risk of mortality from cardiovascular disease, bone disorders, and metabolic disorders is well reported in women with no history of cancer, after surgical oophorectomy or premature ovarian failure. Vasomotor symptoms, urogenital atrophy, weight gain, sexual dysfunction, cognitive decline, and sleep disturbances contribute to the increased non-compliance associated with OFS, especially in younger women. Balancing the toxicities of prolonged OFS with its benefits should be critically analyzed by providers when making recommendations for their patients. Supportive care to manage multi-system toxicities and to counteract the long-term impact on all-cause mortality should be emphasized by every cancer program. Future studies with OFS should incorporate patient outcomes and strategies for symptom management in addition to focusing on improving disease outcomes.
诊断为激素受体（HR）阳性乳腺癌的绝经前女性是长期低雌激素的候选者，以改善癌症预后。然而，与卵巢功能抑制（OFS）相关的毒性超过了疾病获益，而后者往往报道不足。
在没有癌症病史的女性中，接受过手术卵巢切除术或过早卵巢功能衰竭的女性，心血管疾病、骨骼疾病和代谢紊乱的死亡率风险增加已得到充分报道。血管舒缩症状、泌尿生殖系统萎缩、体重增加、性功能障碍、认知能力下降和睡眠障碍都会导致与 OFS 相关的不依从性增加，尤其是在年轻女性中。在为患者提供建议时，提供者应仔细分析延长 OFS 的毒性与其益处之间的平衡。每个癌症项目都应强调支持性护理，以管理多系统毒性，并抵消其对全因死亡率的长期影响。未来的 OFS 研究应将患者结局和症状管理策略纳入其中，除了关注改善疾病结局。
