Expanding role of ovarian suppression/ablation in premenopausal ER-positive breast cancer: issues and opportunities.

Luteinizing hormone-releasing hormone analogs (LHRHa) are often used alone or in combination with tamoxifen to suppress ovarian function in premenopausal women with endocrine-responsive breast cancer. However, aromatase inhitiors (AIs) are now the preferred first-line endocrine treatment for postmenopausal women with breast cancer. Their benefits over tamoxifen in postmenopausal patients and the availability of LHRHa to inhibit ovarian estrogen production in premenopausal women has resulted in much interest in their potential use in combination with AIs in premenopausal breast cancer patients. Preliminary data suggest that the LHRHa goserelin (Zoladex) is active in combination with anastrozole (Arimidex) in premenopausal women with advanced disease, but there are currently few data available in the early breast cancer setting.