Patient: description of disease (onset time, main symptoms, hospitalization, etc.): 48 years old, invasive ductal carcinoma of the left breast was found in October 07, and modified excision was performed in the same month, axillary lymph node positivity was 6/19, ER+++, PR+++, CerBb-2(-),Fish(-) After the operation, 6 courses of chemotherapy and 25 courses of radiotherapy were carried out, and the administration of triamcinolone acetonide and Chinese medicine for more than 2 years. No menstruation since surgery. In more than 2 years of testing found that hormone levels fluctuate, such as January 26 this year, estradiol 0, FSH29.87; March 16, estradiol 10, FSH16.7; April 30, estradiol 59.78, FSH7.72; May 27, estradiol 10, FSH18.93; July 27, estradiol 485, FSH12.84. (Reference values for the perimenopause Estradiol 20-88; follicle stimulating hormone 16.74-133.59.) CA125/CA153/CEA were normal. ultrasound, molybdenum, CT, and brain MRI did not show any abnormality. Last checkup, lipid profile 15.3, endometrium 10mm, multiple cysts on ovaries. Is she a candidate for surgical debulking (lumpectomy)? What are the possible complications of surgical debulking? How to prevent them? Answer: It is endocrine therapy-sensitive breast cancer with axillary lymph node metastasis. From the hormonal point of view: menopause may be due to ovarian hypoplasia caused by chemotherapy and endocrine therapy, and is not true menopause. As for denervation: surgical denervation (lumpectomy and open surgery), drug denervation, radiation therapy denervation, and so on. Surgery is traumatic, but laparoscopic surgery is also very simple and thorough; medication deprogramming for 2-3 years, basically to menopause, and past the period of high recurrence; generally do not radiation therapy. Patient: has performed the debulking surgery on the 25th of this month and is doing well. Today’s hormone levels are as follows: estradiol < 10.0; LH 0.49; FSH 1.72. Is it possible to switch to an aromatase inhibitor now, or should we wait until LH and FSH reach menopausal levels? Besides, some doctors suggested us to remove the uterus, but we didn't take it. I wonder if there are any after-effects of not removing the uterus. Answer: The ovaries have already been removed, which has really achieved the effect of debulking; endocrine therapy can be started, and aromatase inhibitors can be used. There is no need for uterine surgery now; there is no direct link between the uterus and the breasts.