RT Journal
A1 Del Mastro L, Venturini M
T1 GOnadotropin-releasing hormone analogue for premenopausal women with breast cancer—reply
JF JAMA
JO JAMA
YR 2011
FD October 26
VO 306
IS 16
SP 1760
OP 1761
DO 10.1001/jama.2011.1517
UL http://dx.doi.org/10.1001/jama.2011.1517
AB 
In Reply:  Drs Loibl and Gerber question the inclusion in the PROMISE-GIM6 study of patients with hormone receptor–positive breast cancer and patients aged between 40 and 45 years. The majority of young patients with early breast cancer have hormone receptor–positive tumors.1 Therefore, the exclusion of these patients from the trial would have left unanswered the question of ovarian function preservation for most young breast cancer patients. Our data showed that absolute differences in the occurrence of early menopause with the use of triptorelin were −27.9% (95% CI, −47.4% to −8.4%; P = .005) among 51 hormone receptor–negative patients who did not receive tamoxifen and −14.9% (95% CI, −25.1% to −4.7%; P = .004) among 226 hormone receptor–positive patients who received tamoxifen. Although its magnitude is smaller, the protective effect also existed in hormone receptor–positive patients. Similar to the ZORO trial,2 the upper limit for age in the PROMISE-GIM6 study was 45 years. Although patients aged between 40 and 45 years might not be interested in preserving fertility, they might be interested in avoiding early menopause. Such an interest was suggested by their voluntary participation in the study.