Adjuvant Ovarian Suppression in Premenopausal Breast Cancer

New England Journal of Medicine 372(17):1672 (2015) PMID 25901437

To the Editor: The results of the Suppression of Ovarian Function Trial (SOFT) by Francis et al. (Jan. 29 issue)1 are presented as practice changing. However, we are concerned about the emphasis given to the receipt of adjuvant chemotherapy — which was considered as a proxy for a disease at high risk for relapse — as an indication for ovarian-function suppression. In fact, subgroup analyses suggest that the effect of ovarian suppression is also evident, and potentially higher, in small, node-negative, intermediate-grade tumors (i.e., hazard ratios for recurrence, second invasive cancer, or death, 0.45 for tumor diameter <1 cm, 0.69 . . .

DOI: 10.1056/NEJMc1502618