Abstract：
Breast cancer diagnosed in premenopausal women tends to be more aggressive and the benefit of ovarian function suppression (OFS), at least in certain groups of patients, is well known. There is hesitancy in using OFS in some groups of patients who may otherwise benefit from the treatment. For instance, it is clear that in premenopausal patients with hormone receptor-positive (HR+), high-risk, early-stage breast cancer, gonadotropin-releasing hormone agonists (GnRHa) should be given in the adjuvant setting; however, confusion remains whether premenopausal patients with intermediate-risk disease benefit from GnRHa, given the lack of consensus on its definition in guidelines and clinical practice. Most recent evidence on the long-term efficacy of GnRHa, with up to 20-years of follow-up, reinforced its benefits in premenopausal patients with early-stage breast cancer. In this comprehensive review, we reviewed the long-term efficacy in terms of improvement in disease-free survival (DFS) and overall survival (OS) for early-stage HR+ breast cancer and examined evidence from multiple randomized clinical studies to identify the clinicopathological characteristics that correlated with improved DFS and OS with the addition of OFS to adjuvant endocrine therapy. Other aspects of GnRHa, including its efficacy in advanced breast cancer, safety profile, evidence in ovarian function preservation, and the advantages of long-acting formulations were also discussed. By addressing the existing gaps and grey areas regarding the inclusion of OFS as a crucial treatment component for premenopausal breast cancer patients, physicians are more aware of who to administer and the potential impact on survival outcomes.
摘要：
在绝经前女性中诊断出的乳腺癌往往更具侵袭性，并且卵巢功能抑制（OFS）的益处，至少在某些患者群体中，是众所周知的。在一些可能从治疗中受益的患者组中使用OFS存在犹豫。例如,很明显，在激素受体阳性（HR+）的绝经前患者中，高风险,早期乳腺癌,促性腺激素释放激素激动剂（GnRHa）应在佐剂设置中给予；然而，对于绝经前中危疾病患者是否受益于GnRHa，仍然存在困惑，鉴于指南和临床实践对其定义缺乏共识。关于GnRHa长期疗效的最新证据，经过长达20年的随访，加强了其在绝经前早期乳腺癌患者中的益处。在这次全面审查中，我们回顾了早期HR+乳腺癌的无病生存期(DFS)和总生存期(OS)改善方面的长期疗效,并检查了多项随机临床研究的证据,以确定与内分泌辅助治疗中添加OFS后DFS和OS改善相关的临床病理特征.GnRHa的其他方面，包括它对晚期乳腺癌的疗效，安全概况,卵巢功能保存的证据，并讨论了长效制剂的优点。通过解决将OFS作为绝经前乳腺癌患者的关键治疗成分的现有差距和灰色地带，医生更清楚谁来管理以及对生存结局的潜在影响.
