A Cochrane review [Abstract] 1 included 15 studies with a total of 11 538 subjects. Adjuvant endocrine therapy is used for hormone receptor-positive breast cancer and in premenopausal women by oestrogen receptor blockade with tamoxifen, temporary suppression of ovarian oestrogen synthesis by luteinising hormone releasing hormone (LHRH) agonists, and by permanent interruption of ovarian oestrogen synthesis with oophorectomy or radiotherapy. Adding ovarian function suppression (OFS) to treatment resulted in a reduction in mortality (table T1). This treatment effect was seen when OFS was added to observation, to tamoxifen, or to chemotherapy and tamoxifen.
| Outcomes | Relative effect(95% CI) | Risk with control - No ovarian suppression | Risk with intervention - Ovarian suppression | №of participants(studies)Certainty of the evidence |
|---|---|---|---|---|
| Overall survival (OS)5-year risk of deathMedian follow-up: range 5.3 to 12.1 years | HR 0.86(0.78 to 0.94) | 110 per 1000 | 95 per 1000(87 to 104) | 10 374(11) High |
| Disease-free survival (DFS)5-year risk of recurrence Median follow-up: range 5.3 to 12.1 years | HR 0.83(0.77 to 0.90) | 250 per 1000 | 212 per 1000(199 to 228) | 8 899(10) High |
| Toxicity - hot flushes (a combination of "grade 3/4" and "any grade" toxicity)Follow-up: range 2 to 5 years | RR 1.60(1.41 to 1.82) | 97 per 1000 | 154 per 1000(136 to 176) | 5 581(6 ) Low |
| Contralateral breast cancerFollow-up: 4.75 to median 12.1 years3 | RR 0.75(0.57 to 0.97) | 1 per 1000 | 23 per 1000(18 to 30) | 7 856(8) Moderate |
Date of latest search: 2020-08-05
Primary/Secondary Keywords