Breast Cancer Coverage from Every Angle

SABCS 2021: Menopausal Status and Outcomes of Endocrine Therapy With or Without Chemotherapy for Breast Cancer

By: Vanessa A. Carter, BS
Posted: Friday, December 17, 2021

Kevin M. Kalinsky, MD, of Emory University Winship Cancer Institute, Atlanta, and colleagues previously reported that menopausal status may impact invasive and distant disease–free survival among patients with hormone receptor–positive, HER2-negative breast cancer. Their updated outcomes, presented during the 2021 San Antonio Breast Cancer Symposium (Abstract GS2-07), concluded that patients who were premenopausal demonstrated a statistically significant improvement in distant recurrence–free interval, although future work to evaluate whether ovarian function suppression can replace chemotherapy is suggested.

This study enrolled 4,984 patients with hormone receptor–positive, HER2-negative breast cancer who had one to three positive lymph nodes. Distant recurrence–free interval was defined as the time to distant recurrence or death from breast cancer. Post hoc analysis was performed to evaluate invasive disease–free survival among women who were pre- or postmenopausal and did or did not receive ovarian function suppression therapy.

A total of 553 events of invasive disease–free survival were reported at the median follow-up of 6.1 years. Notably, women who were postmenopausal did not experience any invasive or distant disease–free survival benefit with chemotherapy, whereas the 5-year benefits for those who were premenopausal were 5.9% and 3.3%, respectively. In addition, chemotherapy correlated with an improved distant recurrence–free interval for all recurrence score values under 25.

About 12.4% of individuals who were premenopausal had stage pNmi disease, and there was an apparent trend toward a benefit with chemotherapy among these patients (hazard ratio [HR] = 0.44); there were 22 cases of invasive disease–free survival. There was no observed difference in invasive disease–free survival between premenopausal women who did and did not undergo ovarian function suppression. Of note, there was an increase in invasive disease–free survival among participants who stopped having periods as a result of endocrine therapy with or without chemotherapy compared with those who had regular periods.

Disclosure: For full disclosures of the study authors, visit

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