The effect of adding ovarian function suppression to adjuvant endocrine therapy in premenopausal patients with hormone receptor-positive, HER2-positive breast cancer who have undergone neoadjuvant therapy: a single-center experience.

Authors

Okan Aydin, Hale Gulcin Yildirim Dogan, Sermin Dinc Sonusen, Mert Erciyestepe, Ahmet Emin Ozturk, Asli Buyukkuscu, Zehra Sucuoglu Isleyen, Kayhan Erturk

Published in

BMC cancer. Volume 26. Issue 1. Sep 21, 2026. Epub Sep 21, 2026.

Abstract

The role of ovarian function suppression (OFS) in premenopausal patients with hormone receptor (HR)-positive, HER2-positive breast cancer remains unclear in the era of anti-HER2 therapy. This study evaluated the effect of adding OFS to adjuvant endocrine therapy on outcomes in premenopausal patients receiving neoadjuvant anti-HER2 therapy.
We retrospectively reviewed 138 premenopausal patients with HR-positive/HER2-positive non-metastatic breast cancer treated with anti-HER2-based neoadjuvant therapy and surgery between 2015 and 2024. Patients were grouped by receipt of OFS during the adjuvant period. The primary endpoints were disease-free survival (DFS), distant disease-free survival (DDFS), and overall survival (OS); pathological complete response (pCR; ypT0/is ypN0) was evaluated as a secondary endpoint.
Among 138 patients, 60 (43.5%) received OFS. Overall, 42% achieved pCR. After a median follow-up of 56 months, 20 patients (14.5%) recurred or developed metastasis, and 11 (8%) died. Five-year OS rates were 93.9% with OFS and 85.8% without (p = 0.4); DFS rates were 80.7% and 81.3% (p = 0.9). Patients with pCR had excellent survival (5-year OS 100%) irrespective of OFS. In those with residual disease, OFS was associated with numerically higher OS (89.9% vs. 77.6%) but no DFS benefit. Multivariate analysis showed no independent association between OFS and survival outcomes.
In this retrospective real-world study, no independent association between OFS and survival outcomes was observed in premenopausal patients with HR-positive/HER2-positive breast cancer treated with anti-HER2-based neoadjuvant therapy. Patients achieving pCR had excellent prognoses regardless of OFS use. Given the limited statistical power and the predominantly tamoxifen-treated cohort, these findings should be interpreted with caution. Prospective studies are warranted to better define the role of OFS in this patient population.

PMID:
42786451
Bibliographic data and abstract were imported from PubMed on 25 Sep 2026.

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