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William J. Gradishar, MD, FACP, FASCO

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Ovarian Suppression and Breast Cancer Recurrence and Survival

By: Kayci Reyer
Posted: Tuesday, July 11, 2023

Findings from a patient-level meta-analysis presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 503) indicate that altering patients’ ovarian function may improve outcomes in some women with breast cancer. The impact may be greatest among patients with estrogen receptor–positive tumors.

“For premenopausal women aged under 45, ovarian ablation or suppression substantially reduces the 15-year risk of recurrence and death from breast cancer without increasing mortality from other causes,” concluded Professor Richard G. Gray, MA, MSc, of the University of Oxford, United Kingdom, and colleagues.

The analysis included data from 14,993 women with breast cancer across 25 randomized trials. Disease recurrence occurred less often in women who had undergone ovarian ablation or suppression than in those who had not. A significant difference in recurrence rates was observed between women who were confirmed to be premenopausal at the time of ovarian suppression and women whose menopausal status was unclear after chemotherapy, with significantly lower recurrence rates among the known premenopausal group. Among confirmed premenopausal patients, 15-year risks of recurrence and breast cancer mortality were improved by 12.1% and 8.0%, respectively. All-cause mortality was also improved by 7.2%. Deaths without recurrence were not found to have increased.

Of note, an association was identified between patient age and recurrence outcomes among premenopausal patients. Premenopausal women younger than age 45 experienced a substantially reduced recurrence rate versus premenopausal women between the ages of 45 and 54.

Disclosure: Professor Gray reported no conflicts of interest. For full disclosures of the other study authors, visit coi.asco.org.


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