Therapeutic oophorectomy in metastatic breast cancer

Abstract

One hundred five patients undergoing therapeutic oophorectomy for metastatic breast cancer (n = 105) from 1975 to 1985 were reviewed. There were 54 responders (51%) to oophorectomy, with a median duration of response of 16 months (range, 3 to 129 months). Thirty of 42 (71%) estrogen receptor (ER)-positive patients responded to oophorectomy versus five of 24 (21%) ER-negative patients (P less than 0.001). Of the 39 patients with unknown ER status, 19 (49%) responded to oophorectomy. Osseous, soft tissue, and pulmonary metastases responded at similar rates. Of the 16 patients who had received adjuvant chemotherapy, there were five responders (31%) to oophorectomy. Second-line endocrine therapy was effective in 29 of 53 (55%) patients. Fifteen of 28 (54%) ER-positive patients responded to second-line endocrine therapy while two of six (33%) ER-negative patients responded. Twenty-three of 37 (62%) oophorectomy responders responded to second-line endocrine therapy versus six of 16 (38) nonresponders. Oophorectomy appears to be a valuable palliative treatment for metastatic breast cancer. ER-positive patients have the best chance of responding to this therapy. However, ER-negative patients have a reduced but definite chance of responding with a good duration of response. Response to further endocrine treatments is predicted by response to oophorectomy and to a lesser degree by ER status.

What Is the Role of Ovarian Ablation in the Management of Primary and Metastatic Breast Cancer Today?

“…Ovarian ablation was the original systemic therapy for breast cancer and has been in use for more than a hundred years, producing responses in approximately 30% of unselected women with metastatic breast cancer [1,2], and in as many as 80% of women with steroid hormone receptor-positive (HR + ) breast cancer [3,4]. In premenopausal women, the ovaries are the predominant source of estrogen synthesis, with a lesser amount produced by peripheral aromatization of androgens.…”

Endocrine Therapy in Premenopausal Hormone Receptor Positive/Human Epidermal Growth Receptor 2 Negative Metastatic Breast Cancer: Between Guidelines and Literature

“…It promptly reduces circulating estrogens but causes permanent fertility loss and requires hospitalization. Oophorectomy and ovarian irradiation have been considered equally effective, with overall response rate (ORR) ranging from 30% to 79% . Reversible medical ovarian function suppression (OFS) can be accomplished via the administration of luteinizing hormone‐releasing hormone (LHRH) agonists.…”

Hormonoterapia en el cáncer de mama

“…[28][29][30] El efecto protector de la ovariectomía es mayor en mujeres premenopáusicas de menos de 50 años al momento de la operación. 29,31 La ovariectomía es la modalidad de supresión ovárica más coste-efectiva.…”