Answer:

Endocrine-positive breast cancer is a type of cancer that responds to endocrine therapy. Breast cancer cells have receptors (a type of protein) that attach to estrogen and progesterone hormones to grow. In women, these hormones are primarily produced by the ovaries.

For post-menopausal women, the ovaries cease to function. Estrogen is mainly produced in very small amounts by fat tissue and the adrenal glands. Doctors may prescribe medication for 5-10 years to inhibit these hormones, aiming to reduce the risk of recurrence.

However, in younger, pre-menopausal women, the ovaries are the primary source of estrogen, producing it in large quantities. Suppressing ovarian function combined with endocrine therapy helps reduce the recurrence rate in high-risk, endocrine-receptor-positive breast cancer patients. Ovarian function can be temporarily suppressed using GnRHa or through long-term methods such as surgical removal of the ovaries or radiation therapy.

Doctor Hieu and the oncology surgery team perform surgery on a patient. Photo: Tam Anh General Hospital

Ovarian removal surgery rapidly reduces estrogen levels in the blood but carries risks related to anesthesia and the surgical procedure. This method is typically advised for women who no longer wish to have children, have a high risk of cancer recurrence, carry mutated genes, have a high likelihood of developing ovarian cancer, or for whom ovarian function suppression with medication is ineffective or undesirable.

Additionally, ovarian removal surgery is applied to pre-menopausal breast cancer patients with endocrine-positive, HER2-negative, advanced, or metastatic disease who require ovarian function suppression to achieve post-menopausal status before switching to a different endocrine regimen.

You should take your sister to an oncology specialist hospital for examination and appropriate treatment consultation. The doctor needs to discuss thoroughly to weigh the benefits of disease control against the associated side effects.

Doctors select different suppression methods based on each patient's characteristics. Ovarian removal surgery can be performed either simultaneously with breast cancer surgery or after a period of ineffective endocrine-suppressing medication.

Patients may experience side effects such as hot flashes, night sweats, vaginal dryness, decreased libido, risk of osteoporosis, and mood swings.

Level One Specialist Doctor Mai Trung Hieu

Department of Oncology Surgery

Oncology Center

Tam Anh General Hospital, TP HCM