Abstract
This article reviews the use of luteinizing-hormone-releasing hormone (LHRH) agonists in pre- or perimenopausal women with hormone-receptor-positive breast cancer. Estimates of efficacy from systematic reviews, based on several randomized trials, are provided. These show that LHRH agonists can reduce the risk of recurrence and death, and can be an alternative to chemotherapy, particularly for women who would like to avoid early menopause. The benefits can be seen 10 or 15 years later. The main side effects – hot flashes and reduction in bone density – often recede once treatment stops. Ongoing research will provide information about LHRH agonists when used with modern chemotherapy regimens and aromatase inhibitors.