Abstract
Background: We conducted this study to identify factors associated with the onset and reversibility of chemotherapy-induced amenorrhea in Yalgado Ouedraogo Teaching Hospital of Ouagadougou. Methods: A historical cohort study was performed and covered the period from 1 January 2014 to 31 July 2015. No menopausal patients managed for a histologically confirmed breast carcinoma and having benefited from chemotherapy were included in the study. Logistic regression analysis was used to determine the factors associated with the occurrence of chemotherapy-induced amenorrhea as well as its reversibility. Results: Seventy patients were included. The mean age was 38.5 years. Thirteen patients were obese and 19 (40.4%) had their menarche after age of 15 years. Adjuvant chemotherapy was administered to 31 patients while 12 had received neoadjuvant chemotherapy. Sequential chemotherapy with an anthracycline and a taxanetherapeutic protocol was the most used. Forty-seven patients had a chemotherapy-induced amenorrhea. The risk of having a chemotherapy-induced amenorrhea increases by 25% for each additional year of age at diagnosis of cancer (p = 0.0001). Obesity and menarche after age 15 were found to be protective factors. After adjusting these variables together, age, obesity, and age at menarche were factors independently associated with the occurrence of the chemotherapy-induced amenorrhea. The reversibility was effective in 11 cases (37.9%) and especially concerned patients younger than 40 years (p = 0.03). Conclusion: Age is the primary risk factor. Reliable markers of ovarian function need to be developed to better select fertility conservation protocols.
Highlights
Breast cancer is the leading cancer in women worldwide
Adjuvant chemotherapy was administered to 31 patients while 12 had received neoadjuvant chemotherapy
The risk of having a chemotherapy-induced amenorrhea increases by 25% for each additional year of age at diagnosis of cancer (p = 0.0001)
Summary
Breast cancer is the leading cancer in women worldwide. Almost a third (32.7%) of patients affected by this disease are under 50 years [1], so probably no menopausal. The loss of fertility, which is a consequence of ovarian function suppression, often concerns patients of childbearing age with breast cancer [3]. The main risk factors are age, chemotherapy protocols and cumulative doses [4] [5]. The risk of loss of fertility in women treated for breast cancer is important because of the direct effect of cytotoxic drugs on ovarian function and pregnancy proscriptions imposed by the long duration of treatment [7]. These patients expressed the need for information on fertility preservation strategies and their chances of subsequent procreation. We conducted this study to identify factors associated with the onset and reversibility of chemotherapy-induced amenorrhea in our context, to help improve the quality of life of patients by providing answers to the questions related to chemotherapy-induced amenorrhea
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