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Objective: Taking tamoxifen orally is the main endocrine therapy of the premenopausal breast cancer with positive hormone receptor, but numerous patients developed to be advanced refractory breast cancer because of drug resistance.Our study investigated a role of the combination of bilateral oophorectomy and exemestane in the management of advanced refractory breast cancer. Methods: The bilateral oophorectomy was carried out in 17 patients. One week after the operation,exemestane was taken orally (25 mg/d). The median time to progression (TTP), the median survival time and the survival rate were calculated using Kaplan-Meier methods. Results: Seventeen patients age ranged from 26 to 44 years (median, 36 years) were treated with an overall response rate of 64.70%, TTP was 8 months and the median survival time was 31 months.The survival rate of 1-year, 3 years and 5 years was 88.24%, 64.71%, 29.41%, respectively. There have no grade Ⅲ/Ⅳ side effects appeared. Conclusion: Bilateral oophorectomy combined with exemestane is safe and effective for advanced refractory premenopausal breast cancer with positive hormone receptor and it is well-tolerated.