What is your strategy for ovarian suppression if unable to achieve goal estradiol levels with leuprolide 3.75mg monthly dose?  

Data from the SOFT/TEXT trials showed clinical benefit in ovarian suppression + aromatase inhibition for high risk, premenopausal women with hormone receptor positive breast cancer, making ovarian suppression a consideration that can be achieved in numerous ways. Do you titrate the dose of leuprolide, switch to goserelin, discuss oophorectomy, refer to Radiation Oncology for ovarian ablation or abandon ovarian suppression + AI altogether and go back to treating a premenopausal women with tamoxifen?



Answer from: Medical Oncologist at Academic Institution

Answer from: Medical Oncologist at Academic Institution

Answer from: Medical Oncologist at Community Practice