Hormone Ther and Premenopausal

I have a question regarding hormonal therapy.  I have been treated off and on for breast cancer since  1995. I have been on tamoxifen, arimidex, and am now on aromasin.  Most of these hormonal meds are for post-menopausal women. The information never says anything about pre-menopausal women. After each cycle of chemo (I have almost been through them all) my menstrual cycle had come back.  The oncologist years ago recommended having my ovaries removed, but I refused because I wanted another child. Well, now  I am 39 and do not want to have anymore children but I still do not want to have my ovaries removed.  Would Lupron injections seem to help? The cancer went from breast to bone and my tumor marker is almost to the normal range (38) it is now at 136. I am also still on taxol since 1999. Thanks for the reply

[CCF-RN,MSN-rf]

Dear lees:  Tamoxifen is approved for estrogen receptor positive breast cancer in both pre and post menopausal women.  Although menstruation may cease for some women, it is not a necessary response.  Tamoxifen is a selective estrogen modulator and is thought to lower estrogen levels in the breast and not necessarily lowering these levels in the ovaries.  Menstruating while on tamoxifen is not indicative of it's effectiveness or ineffectiveness.  This is why barrier contraception is recommended - technically one can still get pregnant.  Arimidex and Aromasin are for advanced breast cancer in postmenopausal women.  There is no data on its use in premenopausal women.  For metastatic breast cancer, chemotherapy is the usual recommendation.  You may also ask about Aredia (for the bone metastasis).  Radiation therapy may be used if the bone disease is causing discomfort.  The use of tumor markers in breast cancer is controversial.  If there is disease that can be seen on a scan - that is enough data to determine whether treatment is needed.