title: Adjuvant therapy for premenopausal patients with early breast cancer.
abstract: OBJECTIVE
  Current topics on adjuvant therapy for premenopausal patients with breast cancer are reviewed.
  
  
  RESULTS
  The Early Breast Cancer Trialists' Collaborative Group overview showed that women under 50 received a remarkable benefit from postoperative chemotherapy and endocrine therapy. The impact of chemotherapy-induced amenorrhea on patient outcome remains to be defined. The addition of luteinizing-hormone-releasing hormone agonists to tamoxifen, chemotherapy or both significantly reduced both recurrence and death in premenopausal patients with endocrine-responsive breast cancer. Exploratory trials are investigating the use of more complete estrogen suppression with luteinizing-hormone-releasing hormone agonists with aromatase inhibitors. There is no consensus on how long these agonists should be used in the adjuvant setting. Chemotherapy-induced ovarian failure is frequently associated with infertility. The suppression of ovarian function using luteinizing-hormone-releasing hormone agonists during chemotherapy seems promising for preserving ovarian function. Chemotherapy-induced ovarian failure and prolonged luteinizing-hormone-releasing hormone agonist therapy cause premature menopausal symptoms. To minimize the menopausal symptoms, intervention strategies should be investigated.
  
  
  CONCLUSIONS
  There are a number of unresolved issues in terms of the optimal use of chemotherapy and endocrine therapy in premenopausal patients with breast cancer. Well-designed and well-organized randomized clinical trials are essential to resolve these issues.
authors.affiliation: Department of Breast and Thyroid Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan. kure@med.kawasaki-m.ac.jp
authors.forename: Junichi
authors.initials: J
authors.lastname: Kurebayashi
mesh_terms: D000568:Amenorrhea / Q000139:chemically induced; D047072:Aromatase Inhibitors / Q000494:pharmacology; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D017697:Premenopause; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced; D016032:Randomized Controlled Trials as Topic
chemical_list: D047072:Aromatase Inhibitors; D007987:Gonadotropin-Releasing Hormone