Tamoxifen and Ovarian Function Suppression

Combining tamoxifen with ovarian function suppression is a common treatment modality for women with breast cancer. Researchers at the Dana-Farber Cancer Institute in Boston conducted a cohort study of symptoms experienced by women newly diagnosed with breast cancer and collected patient-reported symptoms and quality of life (QOL) measures 1 year after diagnosis.

Symptom severity as reported on the Breast Cancer Prevention Trial checklist was compared between women on ovarian function suppression plus tamoxifen and women taking tamoxifen alone. Differences in mean QOL scores between the two groups were compared using the physical, psychosocial, and sexual subscales of the Cancer Rehabilitation Evaluation System (CARES). Women enrolled in the study were aged 40 or younger, and 106 women (24% of the 444 women with stage 0-III taking tamoxifen) reported ovarian function suppression use.

Among the 333 who had received chemotherapy, the women taking ovarian function suppression medications had higher mean CARES scores—which indicate a lower QOL—on the three subscales. Mean scores for the 111 women who did not receive chemotherapy did not differ significantly between groups.

In the chemotherapy group, women on ovarian suppression plus tamoxifen reported significantly more “moderately bothersome” menopausal symptoms than those on tamoxifen alone. The reported symptoms included hot flashes, night sweats, vaginal dryness, difficulty concentrating, and weight gain. Among women who did not receive chemotherapy, hot flashes, night sweats, and vaginal dryness were reported by women on ovarian function suppression and tamoxifen compared with tamoxifen alone.

The researchers concluded that early intervention to reduce symptom burden should be offered to young women with breast cancer who are receiving tamoxifen along with medications to suppress ovarian function suppression.

Rosenberg SM, Ruddy KJ, Tamimi RM, et al. Ovarian function suppression, symptom burden, and quality of life in young women with breast cancer: A prospective study. J Clin Oncol. 2015:33;(suppl; abstr 515).