卵巢功能抑制（OFS）对患有激素受体（HR）阳性乳腺癌的年轻女性有益，但她们面临卵巢功能突破的风险。我们在年龄 ≤ 40 岁的 HR 阳性乳腺癌患者前瞻性队列中评估了促性腺激素释放激素激动剂 (GnRHa) 治疗的内分泌影响。从诊断后 1 年和 4 年抽取的血液样本中测量血浆雌二醇 (E2)、雌酮和卵泡刺激素 (FSH) 水平。比较 GnRHa 治疗期间有和没有 E2 > 2.72 pg/mL 患者的患者特征、无浸润性乳腺癌生存期 (iBCFS) 和总生存期 (OS)。在符合条件的患者中，1 年和 4 年时 E2 > 2.72 pg/mL 的比例分别为 54.7% (46/84) 和 60% (15/25)。 1 年时与 E2 > 2.72 pg/mL 相关的因素是既往未接受化疗 (P = 0.045) 和使用他莫昔芬 (P = 0.009)。中位随访 7 年后，在 I-III 期乳腺癌患者 (N = 74) 中，6 例 (8.1%) E2 > 2.72 pg/mL 和 5 例 (6.8%) E2 出现 iBCFS 事件≤ 2.72 pg/mL (P = 0.893)。在新发转移性乳腺癌患者（N = 12）中，E2> 2.72 pg/mL的6例（50%）和E2 ≤ 2.72 pg/mL的3例（25%）在随访期间死亡（P = 0.052）。需要进行更大规模的研究来探索 GnRHa 不完全抑制 E2 的临床影响，以确保对该人群采用最佳的 OFS 治疗策略。© 2024。作者。

Ovarian function suppression (OFS) benefits young women with hormone receptor (HR)-positive breast cancer but they are at risk for ovarian function breakthrough. We assessed endocrine effects of gonadotropin-releasing hormone agonist (GnRHa) treatment in a prospective cohort of patients aged ≤ 40 years with HR-positive breast cancer. Plasma estradiol (E2), estrone, and follicule-stimulating hormone (FSH) levels were measured from blood samples drawn 1 and 4 years after diagnosis. Patient characteristics, invasive breast cancer-free survival (iBCFS), and overall survival (OS) were compared between those with and without E2 > 2.72 pg/mL during GnRHa treatment. Among eligible patients, 54.7% (46/84) and 60% (15/25) had E2 > 2.72 pg/mL at 1 and 4 years, respectively. Factors associated with E2 > 2.72 pg/mL at 1 year were no prior chemotherapy (P = 0.045) and tamoxifen use (P = 0.009). After a median follow-up of 7 years, among patients with stage I-III breast cancer (N = 74), iBCFS events were seen in 6 (8.1%) with E2 > 2.72 pg/mL and 5 (6.8%) with E2 ≤ 2.72 pg/mL (P = 0.893). Among patients with de novo metastatic breast cancer (N = 12), 6 (50%) with E2 > 2.72 pg/mL and 3 (25%) with E2 ≤ 2.72 pg/mL died during follow-up (P = 0.052). Larger studies exploring the clinical implications of incomplete E2 suppression by GnRHa are needed to ensure optimal OFS treatment strategies are being employed for this population.© 2024. The Author(s).