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Studies have demonstrated that at least half of patients undergoing treatment for breast cancer are concerned about potential infertility and demonstrate interest in becoming pregnant after the conclusion of their treatment. Even those not interested in pregnancy seek to avoid ovarian insufficiency and early menopause, which can negatively impact patients’ quality of life—an important treatment goal.

In the United States, 2 gonadotropin-releasing hormone (GnRH) agonists, goserelin and leuprolide, are widely available for ovarian function suppression (OFS) in patients with breast cancer. The ovarian-protective effects of GnRH agonists are mediated by downregulating GnRH receptors in the pituitary gland, which suppresses the release of luteinizing hormone and follicle-stimulating hormone.

In Latin American countries, the onset of breast cancer is approximately 10 years earlier than in high-income countries. Moreover, the incidence rate of breast cancer in individuals aged <40 years is close to 11%, which is higher than the rates in developed regions such as the United States and the European Union. Additionally, most of these young women are diagnosed with advanced-stage disease.

A growing body of research has demonstrated that 5 to 10 years of adjuvant endocrine therapy (ET) plus ovarian function suppression (OFS) in patients with estrogen receptor (ER)-positive breast cancer reduces disease recurrence and mortality. However, despite this proven benefit, adverse events (AEs) associated with ET plus OFS may have a negative impact on patients’ quality of life.

In addition to the consideration of patient age, treatment selection for advanced breast cancer should include consideration of disease characteristics as outlined in evidence-based guidelines.

The Young Survival Coalition (YSC) is a nonprofit patient advocacy organization in the United States that supports approximately 250,000 patients diagnosed with breast cancer before the age of 40 years.

Navigators remove barriers to care and improve health disparities, but if navigation models aren’t sustainable, patients lose, and health inequities persist.