Ovarian ablation for premenopausal early-stage breast cancer: An update

Ovarian ablation is the oldest form of systemic treatment of breast cancer and consists of removal of the main source of estrogen biosynthesis in prem enopausal women. Over the last century several different means of stopping ovarian function have been studied: surgical oophorectomy, ovarian irradiat ion, and more recently, chemical castration by gonadotropin-releasing hormo ne analog therapy. In unselected patients the response rate to ovarian abla tion is of about 35% but the likelihood of response Is considerably higher for patients with hormonal receptor-positive tumors, the therapy being most effective in women who are actively menstruating. In spite of this evidenc e, the role of ovarian ablation in the management of early-stage breast can cer still remains controversial. Here we review current evidence supporting the value of this ablative procedure as an adjuvant and update ongoing cli nical research to refine our knowledge about its use.