{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T21:50:49Z","timestamp":1773525049062,"version":"3.50.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100017065","name":"Rogel Cancer Center, University of Michigan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Breast Cancer Res Treat"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Ovarian function suppression (OFS) reduces the risk of recurrence of hormone receptor-positive breast cancer but increases the likelihood of toxicity and nonpersistence with endocrine therapy. In addition, rates of OFS utilization are lower than expected. To increase understanding of these issues, we sought to identify patient factors associated with the use of OFS injections, as well as treatment decision-making and education needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this convergent mixed methods designed study, patients receiving OFS, who started then discontinued OFS injections, and who never initiated OFS injections underwent 1:1 semi-structured interviews and completed questionnaires on shared decision-making and medication beliefs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 33 enrolled participants, 30 completed both the questionnaires and the interview. Median age was 43 (range 32\u201355), 24 were white (80%), and 20 (66.7%) had received chemotherapy. Four key themes emerged. (1) There was concern about need for more education, especially about short- and long-term side effects of OFS. (2) For those receiving OFS injections, the decision to take OFS was mainly due to a desire to reduce cancer recurrence risk. (3) For those who stopped OFS, injections were often used as a stop-gap measure, with a preference for permanence of oophorectomy. (4) For those who never took OFS, there was often perceived lack of strong physician recommendation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tailored support for patients is needed to optimize decision-making regarding OFS, related to both potential benefits and risks of OFS in addition to adjuvant endocrine therapy. Educational strategies such as peer mentors or decision aids should be explored in this clinical setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10549-026-07929-1","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T09:53:33Z","timestamp":1771840413000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ovarian function suppression decision-making and uptake in premenopausal women with breast cancer: a mixed methods analysis"],"prefix":"10.1007","volume":"216","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4771-5930","authenticated-orcid":false,"given":"N. L.","family":"Henry","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. K.","family":"Monkman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Griffith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Scheu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Ghormley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Armstrong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Secor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Jasthi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. T.","family":"Hawley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Guetterman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"7929_CR1","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1200\/OP.20.00793","volume":"17","author":"EJ Cathcart-Rake","year":"2021","unstructured":"Cathcart-Rake EJ, Ruddy KJ, Bleyer A, Johnson RH (2021) Breast cancer in adolescent and young adult women under the age of 40 years. JCO Oncol Pract 17:305\u2013313. https:\/\/doi.org\/10.1200\/OP.20.00793","journal-title":"JCO Oncol Pract"},{"key":"7929_CR2","doi-asserted-by":"publisher","first-page":"4384","DOI":"10.1002\/cncr.33846","volume":"127","author":"RE Hendrick","year":"2021","unstructured":"Hendrick RE, Monticciolo DL, Biggs KW, Malak SF (2021) Age distributions of breast cancer diagnosis and mortality by race and ethnicity in US women. Cancer 127:4384\u20134392. https:\/\/doi.org\/10.1002\/cncr.33846","journal-title":"Cancer"},{"key":"7929_CR3","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3322\/caac.21871","volume":"75","author":"RL Siegel","year":"2025","unstructured":"Siegel RL, Kratzer TB, Giaquinto AN, Sung H, Jemal A (2025) Cancer statistics, 2025. CA Cancer J Clin 75:10\u201345. https:\/\/doi.org\/10.3322\/caac.21871","journal-title":"CA Cancer J Clin"},{"key":"7929_CR4","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21863","author":"AN Giaquinto","year":"2024","unstructured":"Giaquinto AN, Sung H, Newman LA, Freedman RA, Smith RA, Star J, Jemal A, Siegel RL (2024) Breast cancer statistics 2024. CA Cancer J Clin. https:\/\/doi.org\/10.3322\/caac.21863","journal-title":"CA Cancer J Clin"},{"key":"7929_CR5","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.1200\/JCO.22.01065","volume":"41","author":"PA Francis","year":"2023","unstructured":"Francis PA, Fleming GF, Lang I, Ciruelos EM, Bonnefoi HR, Bellet M, Bernardo A, Climent MA, Martino S, Bermejo B et al (2023) Adjuvant endocrine therapy in premenopausal breast cancer: 12-year results from SOFT. J Clin Oncol 41:1370\u20131375. https:\/\/doi.org\/10.1200\/JCO.22.01065","journal-title":"J Clin Oncol"},{"key":"7929_CR6","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1200\/JCO.22.01064","volume":"41","author":"O Pagani","year":"2023","unstructured":"Pagani O, Walley BA, Fleming GF, Colleoni M, Lang I, Gomez HL, Tondini C, Burstein HJ, Goetz MP, Ciruelos EM et al (2023) Adjuvant exemestane with ovarian suppression in premenopausal breast cancer: long-term follow-up of the combined TEXT and SOFT trials. J Clin Oncol 41:1376\u20131382. https:\/\/doi.org\/10.1200\/JCO.22.01064","journal-title":"J Clin Oncol"},{"key":"7929_CR7","doi-asserted-by":"publisher","first-page":"1689","DOI":"10.1200\/jco.2015.65.9573","volume":"34","author":"HJ Burstein","year":"2016","unstructured":"Burstein HJ, Lacchetti C, Anderson H, Buchholz TA, Davidson NE, Gelmon KE, Giordano SH, Hudis CA, Solky AJ, Stearns V et al (2016) Adjuvant endocrine therapy for women with hormone receptor-positive breast cancer: American Society of Clinical Oncology Clinical Practice Guideline update on ovarian suppression. J Clin Oncol 34:1689\u20131701. https:\/\/doi.org\/10.1200\/jco.2015.65.9573","journal-title":"J Clin Oncol"},{"key":"7929_CR8","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.annonc.2023.11.016","volume":"35","author":"S Loibl","year":"2024","unstructured":"Loibl S, Andre F, Bachelot T, Barrios CH, Bergh J, Burstein HJ, Cardoso MJ, Carey LA, Dawood S, Del Mastro L et al (2024) Early breast cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 35:159\u2013182. https:\/\/doi.org\/10.1016\/j.annonc.2023.11.016","journal-title":"Ann Oncol"},{"key":"7929_CR9","doi-asserted-by":"publisher","first-page":"1601","DOI":"10.1200\/JCO.2015.64.8675","volume":"34","author":"K Ribi","year":"2016","unstructured":"Ribi K, Luo W, Bernhard J, Francis PA, Burstein HJ, Ciruelos E, Bellet M, Pavesi L, Lluch A, Visini M et al (2016) Adjuvant tamoxifen plus ovarian function suppression versus tamoxifen alone in premenopausal women with early breast cancer: patient-reported outcomes in the suppression of ovarian function trial. J Clin Oncol 34:1601\u20131610. https:\/\/doi.org\/10.1200\/JCO.2015.64.8675","journal-title":"J Clin Oncol"},{"key":"7929_CR10","doi-asserted-by":"publisher","first-page":"3113","DOI":"10.1200\/JCO.2016.72.0946","volume":"35","author":"P Saha","year":"2017","unstructured":"Saha P, Regan MM, Pagani O, Francis PA, Walley BA, Ribi K, Bernhard J, Luo W, Gomez HL, Burstein HJ et al (2017) Treatment efficacy, adherence, and quality of life among women younger than 35 years in the International Breast Cancer Study Group TEXT and SOFT adjuvant endocrine therapy trials. J Clin Oncol 35:3113\u20133122. https:\/\/doi.org\/10.1200\/JCO.2016.72.0946","journal-title":"J Clin Oncol"},{"key":"7929_CR11","doi-asserted-by":"publisher","DOI":"10.1158\/1557-3265.SABCS24-P4-02-07","volume":"31","author":"DL Hershman","year":"2025","unstructured":"Hershman DL, Chen L, Accordino MK, Sathe C, Henry NL, Wright JD (2025) Uptake of ovarian function suppression over time and endocrine therapy adherence among premenopausal women with breast cancer, abstract P4-02-07. Clin Cancer Res 31:P4-02-07","journal-title":"Clin Cancer Res"},{"key":"7929_CR12","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2025.104458","volume":"81","author":"V Muller","year":"2025","unstructured":"Muller V, Horner M, Thill M, Banys-Paluchowski M, Schmatloch S, Fasching PA, Harbeck N, Langanke D, Uhrig S, Haberle L et al (2025) Real-world utilization of aromatase inhibitors, tamoxifen, and ovarian function suppression in premenopausal patients with early hormone receptor-positive, HER2-negative breast cancer with increased recurrence risk. Breast 81:104458. https:\/\/doi.org\/10.1016\/j.breast.2025.104458","journal-title":"Breast"},{"key":"7929_CR13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0173904","volume":"12","author":"H Doherr","year":"2017","unstructured":"Doherr H, Christalle E, Kriston L, Harter M, Scholl I (2017) Use of the 9-item Shared Decision Making Questionnaire (SDM-Q-9 and SDM-Q-Doc) in intervention studies-a systematic review. PLoS ONE 12:e0173904. https:\/\/doi.org\/10.1371\/journal.pone.0173904","journal-title":"PLoS ONE"},{"key":"7929_CR14","first-page":"688","volume":"16","author":"JA Singh","year":"2010","unstructured":"Singh JA, Sloan JA, Atherton PJ, Smith T, Hack TF, Huschka MM, Rummans TA, Clark MM, Diekmann B, Degner LF (2010) Preferred roles in treatment decision making among patients with cancer: a pooled analysis of studies using the Control Preferences Scale. Am J Manag Care 16:688\u2013696","journal-title":"Am J Manag Care"},{"key":"7929_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/08870449908407311","volume":"14","author":"R Horne","year":"1999","unstructured":"Horne R, Weinman J, Hankins M (1999) The beliefs about medicines questionnaire (BMQ): the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health 14:1\u201324","journal-title":"Psychol Health"},{"key":"7929_CR16","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1007\/s10549-025-07734-2","volume":"212","author":"KT Lee","year":"2025","unstructured":"Lee KT, Hu B, Martinez Tyson D, Geiss C, Vadaparampil ST, Jim HSL, Gwede CK, Soliman HH, Henry NL, Hershman DL (2025) A mixed-methods study characterizing experiences of medical oncologists\u2019 use of gonadotropin-releasing hormone agonists for treatment of breast cancer. Breast Cancer Res Treat 212:449\u2013455. https:\/\/doi.org\/10.1007\/s10549-025-07734-2","journal-title":"Breast Cancer Res Treat"},{"key":"7929_CR17","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1200\/JCO.2017.74.8442","volume":"36","author":"ST Hawley","year":"2018","unstructured":"Hawley ST, Li Y, An LC, Resnicow K, Janz NK, Sabel MS, Ward KC, Fagerlin A, Morrow M, Jagsi R et al (2018) Improving breast cancer surgical treatment decision making: the iCanDecide randomized clinical trial. J Clin Oncol 36:659\u2013666. https:\/\/doi.org\/10.1200\/JCO.2017.74.8442","journal-title":"J Clin Oncol"},{"key":"7929_CR18","doi-asserted-by":"publisher","first-page":"4864","DOI":"10.1200\/JCO.23.00557","volume":"41","author":"SY Baek","year":"2023","unstructured":"Baek SY, Noh WC, Ahn SH, Kim HA, Ryu JM, Kim SI, Lee EG, Im SA, Jung Y, Park MH et al (2023) Adding ovarian suppression to tamoxifen for premenopausal women with hormone receptor-positive breast cancer after chemotherapy: an 8-year follow-up of the ASTRRA trial. J Clin Oncol 41:4864\u20134871. https:\/\/doi.org\/10.1200\/JCO.23.00557","journal-title":"J Clin Oncol"},{"key":"7929_CR19","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1200\/OP-24-00502","volume":"21","author":"CM Kelly","year":"2025","unstructured":"Kelly CM, Bennett KE, Cahir C, Eisen A, Pusztai L (2025) Clinical management of ovarian function suppression in premenopausal women with breast cancer: a survey of members of ASCO. JCO Oncol Pract 21:654\u2013662. https:\/\/doi.org\/10.1200\/OP-24-00502","journal-title":"JCO Oncol Pract"}],"container-title":["Breast Cancer Research and Treatment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10549-026-07929-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10549-026-07929-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10549-026-07929-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T21:01:48Z","timestamp":1773522108000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10549-026-07929-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,23]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["7929"],"URL":"https:\/\/doi.org\/10.1007\/s10549-026-07929-1","relation":{},"ISSN":["0167-6806","1573-7217"],"issn-type":[{"value":"0167-6806","type":"print"},{"value":"1573-7217","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,23]]},"assertion":[{"value":"29 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"NLH has received consultant honoraria from AstraZeneca, Daiichi Sankyo, and Genentech and royalties from Up-to-Date, none of which are relevant to this manuscript. No other authors have relevant financial interests to report.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The University of Michigan Institutional Review Board granted an exemption #2 for this mixed methods study (HUM00262102).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"Verbal informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}}],"article-number":"17"}}