Важность оценки функции яичников у женщин при назначении эндокринотерапии рака молочной железы

Эффективность добавления овариальной супрессии к тамоксифену или к ингибиторам ароматазы после адъювантной химиотерапии для женщин моложе 35 лет или старше, но при наличии хотя бы одного фактора высокого риска рецидива доказана в рандомизированных клинических исследованиях.

Однако отсутствие четких критериев оценки функции яичников после проведения гонадотоксичной химиотерапии, особенно у женщин в перименопаузе, значительно затрудняет выбор правильной тактики эндокринотерапии. Несмотря на доказанную эффективность в исследованиях SOFT и TEXT ингибиторов ароматазы в адъювантной терапии рака молочной железы у женщин с сохраненной функцией яичников, по мнению многих экспертов, данная тактика требует более дифференцированного подхода.

На основании международных исследований, имеющихся в литературе, по особенностям менструального цикла у женщин с гормоночувствительным раком молочной железы после химиотерапии были выделены относительные факторы (критерии STRAW, возраст, гонадотоксичность химиотерапии) определения вероятности восстановления функции яичников. Внедрение данных методов оценки овариальной функции после химиотерапии у женщин в пременопаузе в клинические рекомендации по адъювантному лечению раннего рака молочной железы, возможно, сделает выбор в пользу овариальной супрессии более обоснованным не только с клинической, но и с физиологической точки зрения.

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