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Do you routinely check hormone levels to confirm postmenopausal status before adding aromatase inhibitors to OFS in premenopausal women with early breast cancer?

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In premenopausal women with early breast cancer, do you routinely check hormone levels to confirm ovarian suppression before adding an aromatase inhibitor?

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3 Answers
Mednet Member
Mednet Member
Medical Oncology · Providence Hood River Memorial Hospital
Answered on

I avoid the issue by taking a sequential approach. I typically start premenopausal women on tamoxifen, then add OFS 4-6w later depending on their tolerance of tamoxifen, and then change to an AI after another 6-12 weeks.

It is easy to underestimate the severity of side effects that many premenopausa...

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Mednet Member
Mednet Member
Medical Oncology · University of Chicago – Department of Medicine
Answered on

I check hormone levels to confirm the efficacy of ovarian suppression – but not specifically prior to adding an aromatase inhibitor. For example, in the TREND trial, it took a median of 14 days to achieve estradiol <2.7 pg/mL, and all patients achieved optimal ovarian suppression by the end of the f...

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Mednet Member
Mednet MemberInvited Expert
Medical Oncology · University of Michigan Medical School
Answered on

For patients who are starting GnRH agonist therapy, I routinely check hormone levels to confirm ovarian suppression before adding an aromatase inhibitor. A small proportion of patients do not achieve suppression of ovarian function (Bellet et al., PMID 26729437), although the clinical implications o...

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