@article {Oseledchyk222, author = {Anton Oseledchyk and Mary L Gemignani and Qin C Zhou and Alexia Iasonos and Rahmi Elahjji and Zara Adamou and Noah Feit and Shari B Goldfarb and Kara Long Roche and Yukio Sonoda and Deborah J Goldfrank and Dennis S Chi and Sally S Saban and Vance Broach and Nadeem R Abu-Rustum and Jeanne Carter and Mario Leitao and Oliver Zivanovic}, title = {Surgical ovarian suppression for adjuvant treatment in hormone receptor positive breast cancer in premenopausal patients}, volume = {31}, number = {2}, pages = {222--231}, year = {2021}, doi = {10.1136/ijgc-2020-001966}, publisher = {BMJ Specialist Journals}, abstract = {Objective Ovarian suppression is recommended to complement endocrine therapy in premenopausal women with breast cancer and high-risk features. It can be achieved by either medical ovarian suppression or therapeutic bilateral salpingo-oophorectomy. Our objective was to evaluate characteristics of patients with stage I{\textendash}III hormone receptor positive primary breast cancer who underwent bilateral salpingo-oophorectomy at our institution.Materials and methods Premenopausal women with stage I{\textendash}III hormone receptor positive primary breast cancer diagnosed between January 2010 and December 2014 were identified from a database. Patients with confirmed BRCA1/2 mutations were excluded. Distribution of characteristics between treatment groups was assessed using χ2 test and univariate logistic regression. A multivariate model was based on factors significant on univariate analysis.Results Of 2740 women identified, 2018 (74\%) received endocrine treatment without ovarian ablation, 516 (19\%) received endocrine treatment plus ovarian ablation, and 206 (7.5\%) did not receive endocrine treatment. Among patients undergoing ovarian ablation 282/516 (55\%) received medical ovarian suppression, while 234 (45\%) underwent bilateral salpingo-oophorectomy. By univariate logistic analyses, predictors for ovarian ablation were younger age (OR 0.97), histology (other vs ductal: OR 0.23), lymph node involvement (OR 1.89), higher International Federation of Gynecology and Obstetrics (FIGO) stage (stage II vs I: OR 1.48; stage III vs I: OR 2.86), higher grade (grade 3 vs 1: OR 3.41; grade 2 vs 1: OR 2.99), chemotherapy (OR 1.52), and more recent year of diagnosis (2014 vs 2010; OR 1.713). Only year of diagnosis, stage, and human epidermal growth factor receptor 2 (HER-2) treatment remained significant in the multivariate model. Within the cohort undergoing ovarian ablation, older age (OR 1.05) was associated with therapeutic bilateral salpingo-oophorectomy. Of 234 undergoing bilateral salpingo-oophorectomy, 12 (5\%) mild to moderate adverse surgical events were recorded.Conclusions Bilateral salpingo-oophorectomy is used frequently as an endocrine ablation strategy. Older age was associated with bilateral salpingo-oophorectomy. Perioperative morbidity was acceptable. Evaluation of long-term effects and quality of life associated with endocrine ablation will help guide patient/provider decision-making.}, issn = {1048-891X}, URL = {https://ijgc.bmj.com/content/31/2/222}, eprint = {https://ijgc.bmj.com/content/31/2/222.full.pdf}, journal = {International Journal of Gynecologic Cancer} }