How do you monitor ovarian function in high risk, premenopausal breast cancer patients receiving adjuvant ovarian suppression?

Great question. Extremely clinically relevant. Here's the problem with 'medical oophorectomy': ABCSG-12 showed that OFS+AI in premenopausal women who were overweight had a 50% increased risk for disease recurrence. SOFT trial sub-study, SOFT-EST, showed that one in three women on OFS+AI have subopti...

Ideal is not known. I typically measure estradiol trough levels after 3 months of ovarian suppression. About 15% of premenopausal women do not get adequate ovarian suppression with monthly GNRH agonists.

If estradiol is detected, then I might go an additional month and recheck. If still detectable,...