PT  - JOURNAL ARTICLE
AU  - Oseledchyk, Anton
AU  - Gemignani, Mary L
AU  - Zhou, Qin C
AU  - Iasonos, Alexia
AU  - Elahjji, Rahmi
AU  - Adamou, Zara
AU  - Feit, Noah
AU  - Goldfarb, Shari B
AU  - Long Roche, Kara
AU  - Sonoda, Yukio
AU  - Goldfrank, Deborah J
AU  - Chi, Dennis S
AU  - Saban, Sally S
AU  - Broach, Vance
AU  - Abu-Rustum, Nadeem R
AU  - Carter, Jeanne
AU  - Leitao, Mario
AU  - Zivanovic, Oliver
TI  - Surgical ovarian suppression for adjuvant treatment in hormone receptor positive breast cancer in premenopausal patients
AID  - 10.1136/ijgc-2020-001966
DP  - 2021 Feb 01
TA  - International Journal of Gynecologic Cancer
PG  - 222--231
VI  - 31
IP  - 2
4099  - http://ijgc.bmj.com/content/31/2/222.short
4100  - http://ijgc.bmj.com/content/31/2/222.full
SO  - Int J Gynecol Cancer2021 Feb 01; 31
AB  - 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–III hormone receptor positive primary breast cancer who underwent bilateral salpingo-oophorectomy at our institution.Materials and methods Premenopausal women with stage I–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.