Ovarian suppression failure during GnRH agonist treatment: A report of three breast cancer patients

J Gynecol Obstet Hum Reprod. 2018 Jun;47(6):261-264. doi: 10.1016/j.jogoh.2018.03.002. Epub 2018 Mar 3.

Abstract

In premenopausal women treated for breast cancer, endocrine therapy combining an aromatase inhibitor (AI) and a gonadotropin-releasing hormone (GnRH) agonist (GA) for ovarian suppression may be indicated in high-risk or in metastatic cancer. AIs are effective in premenopausal women only when ovarian estrogen production is suppressed, a state achievable through the use of GAs. However, a complete suppression sometimes proves elusive. We report here three cases of ovarian suppression failure in premenopausal breast cancer patients who received adjuvant AI+GA. Frequency of GA administration, BMI, and young age could affect gonadotropin suppression and may be implied in these failures. Clinical monitoring of these patients is advisable, and hormone assays and pelvic ultrasound should be performed in case of symptoms of estrogen activity.

Keywords: Breast cancer; Endocrine therapy; Estradiol; GnRH agonist; Ovarian suppression; Premenopausal.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aromatase Inhibitors / administration & dosage
  • Aromatase Inhibitors / pharmacology*
  • Breast Neoplasms / drug therapy*
  • Chemotherapy, Adjuvant
  • Drug Therapy, Combination
  • Female
  • Gonadotropin-Releasing Hormone / administration & dosage
  • Gonadotropin-Releasing Hormone / agonists
  • Gonadotropin-Releasing Hormone / pharmacology*
  • Humans
  • Ovary / drug effects*

Substances

  • Aromatase Inhibitors
  • Gonadotropin-Releasing Hormone