TY - JOUR
T1 - Goserelin toxicities and preferences for ovarian suppression method in pre-menopausal women with breast cancer
AU - Hsin-Chieh Hsieh, Amy
AU - Kichenadasse, Ganessan
AU - Vatandoust, Sina
AU - Roy, Amitesh
AU - Sukumaran, Shawgi
AU - Karapetis, Christos
AU - Martin, Hilary
AU - Chong, L C
AU - Koczwara, Bogda
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background: Goserelin, a form of medical ovarian suppression, is an effective treatment for pre-menopausal women with breast cancer (PMBC). Meta-analysis data showed that similar efficacy is achieved with medical ovarian suppression and non-pharmacological ovarian suppression (NPOS) – oophorectomy or ovarian irradiation. The acceptance rate of NPOS remains low. Aims: This study explored the reported toxicities of PMBC women and their preferred ovarian suppression method whilst on goserelin. Methods: A postal survey consisting of 22 study-specific questions was sent to PMBC women who received goserelin at the Flinders Medical Centre. Results: Nineteen women were identified from the database; 12 versus 7 women received goserelin in the adjuvant versus metastatic setting respectively. Thirteen (68.4%) responded to the survey. Women in the adjuvant cohort were more likely to report toxicities. The most common were hot flushes (100% vs 50% P = 0.033), myalgia/arthralgia (71.4% vs 16.7%, P = 0.048) and decreased libido (57/1% vs 16.7%, P = 0.135). NPOS was recalled to be offered to five (38.5%) women, with acceptance by one BRCA2 carrier. NPOS was declined initially due to fear of procedure, surgical/anaesthetic risk, invasiveness and planned future pregnancies. If given the option, upfront oophorectomy was indicated in seven (53.8%) women due to inconveniences with monthly goserelin. Conclusion: Half of PMBC women indicated a preference to NPOS, but only a minority recollected NPOS being discussed. Inconvenience with monthly goserelin is the main driver toward a preference of favouring NPOS. Clarification from larger trials that research patients’ decision process and preferences regarding ovarian suppression is needed to validate our findings.
AB - Background: Goserelin, a form of medical ovarian suppression, is an effective treatment for pre-menopausal women with breast cancer (PMBC). Meta-analysis data showed that similar efficacy is achieved with medical ovarian suppression and non-pharmacological ovarian suppression (NPOS) – oophorectomy or ovarian irradiation. The acceptance rate of NPOS remains low. Aims: This study explored the reported toxicities of PMBC women and their preferred ovarian suppression method whilst on goserelin. Methods: A postal survey consisting of 22 study-specific questions was sent to PMBC women who received goserelin at the Flinders Medical Centre. Results: Nineteen women were identified from the database; 12 versus 7 women received goserelin in the adjuvant versus metastatic setting respectively. Thirteen (68.4%) responded to the survey. Women in the adjuvant cohort were more likely to report toxicities. The most common were hot flushes (100% vs 50% P = 0.033), myalgia/arthralgia (71.4% vs 16.7%, P = 0.048) and decreased libido (57/1% vs 16.7%, P = 0.135). NPOS was recalled to be offered to five (38.5%) women, with acceptance by one BRCA2 carrier. NPOS was declined initially due to fear of procedure, surgical/anaesthetic risk, invasiveness and planned future pregnancies. If given the option, upfront oophorectomy was indicated in seven (53.8%) women due to inconveniences with monthly goserelin. Conclusion: Half of PMBC women indicated a preference to NPOS, but only a minority recollected NPOS being discussed. Inconvenience with monthly goserelin is the main driver toward a preference of favouring NPOS. Clarification from larger trials that research patients’ decision process and preferences regarding ovarian suppression is needed to validate our findings.
KW - goserelin
KW - ovarian suppression
KW - pre-menopausal women
KW - breast cancer
KW - Preference
KW - preference
UR - http://www.scopus.com/inward/record.url?scp=84992152286&partnerID=8YFLogxK
U2 - 10.1111/imj.13169
DO - 10.1111/imj.13169
M3 - Article
VL - 46
SP - 1153
EP - 1159
JO - Internal Medicine Journal
JF - Internal Medicine Journal
SN - 0004-8291
IS - 10
ER -