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The potential equivalence of 3-monthly (3\u00a0M) versus monthly (1\u00a0M) schedules has been suggested but remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a systematic review and meta-analysis of interventional studies comparing 3\u00a0M and 1\u00a0M GnRHa regimens in premenopausal women with HR\u2009+\u2009BC receiving endocrine therapy. Outcomes included ovarian escape (OE), mean estradiol (E2) levels, disease-free survival (DFS), progression-free survival (PFS), and adverse events. Subgroup analyses were performed by estradiol assay type, and a sensitivity analysis restricted to RCTs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifteen studies comprising 4,324 patients were included, of whom 2,098 (48%) received a 3\u00a0M regimen. The pooled OE was 10% and showed no significant difference between schedules (RR 0.86; 95% CI 0.60\u20131.22; p\u2009=\u20090.39). Ultrasensitive assays yielded higher OE detection (31%) without inter-regimen differences (RR 0.90; 95% CI 0.38\u20132.14). Mean E2 concentrations at 12\u00a0weeks were similar (MD 1.36\u00a0pg\/mL; 95% CI \u20133.66 to 6.38), with consistent findings in RCT-only analyses (MD \u20131.77\u00a0pg\/mL; 95% CI \u20135.71 to 2.17). DFS (RR 1.02; 95% CI 0.67\u20131.56) and PFS (RR 0.86; 95% CI 0.72\u20131.04) were also comparable. No clinically relevant differences were observed in reported safety outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>3\u00a0M GnRHa achieved OFS efficacy comparable to 1\u00a0M regimens, with no meaningful differences in survival or safety. The findings support 3\u00a0M GnRHa as a valid and practical alternative for OFS in appropriately selected premenopausal women with HR\u2009+\u2009BC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10549-026-07960-2","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:29:23Z","timestamp":1781245763000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Three-monthly gonadotropin-releasing hormone agonist for ovarian function suppression in premenopausal breast cancer: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"217","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6567-2217","authenticated-orcid":false,"given":"Caio Dabbous","family":"de Liz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8710-1784","authenticated-orcid":false,"given":"Pedro C. 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