The aim of the current study was to determine the feasibility, efficacy and safety of ovarian
castration by high-intensity focused ultrasound (HIFU) in premenopausal patients with
estrogen receptor (ER)(+)/
progesterone receptor (PR)(+)
breast cancer subsequent to
radical mastectomy. A total of 88 premenopausal females with pathologically confirmed ER(+)/PR(+)
breast cancer following
radical mastectomy were randomly and equally divided into two groups that received
HIFU therapy or
radiation treatment.
HIFU therapy was applied twice at an interval of three days and
radiotherapy was administered to a total prescribed dose of D(
T) 18 Gy in nine fractions over 11 days. Outcome measures included serum levels of
estradiol and
estrone, the Kupperman index and the incidence of secondary
amenorrhea. Adverse events were monitored and recorded. All patients were followed up for 12 months. Serum levels of
estradiol and
estrone were comparable prior to treatment between the HIFU and
radiation treatment groups. One month following treatment, serum levels of
estradiol and
estrone were significantly decreased in the two groups, but a greater decline was observed in the HIFU treatment group (P<0.01 and 0.05, respectively). In addition, more patients developed severe menopausal symptoms and
amenorrhea in the
HIFU therapy group compared with the
radiotherapy group (P<0.01 for the two groups). A total of 3 months following treatment, serum levels of
estradiol and
estrone and the distribution of patients with severe, moderate and mild menopausal symptoms were comparable between the two groups. Following nine menstrual cycles, the incidence of
amenorrhea reached 100% in the two groups.
HIFU therapy is superior to
radiotherapy for ovarian
castration in premenopausal females with ER(+)/PR(+)
breast cancer subsequent to
radical mastectomy in terms of its minimal invasiveness and faster efficacy. HIFU represents a feasible non-surgical approach for ovarian
castration.