Menstrual and Hormonal Changes in Breast Cancer Patients Treated By Ad- juvant, Adriamycin and Cyclophosphamide Chemotherapy

Abstract

Background and objectives: The long-term effects of adjuvant chemotherapy are very important in patients with breast cancer. Cytotoxic chemotherapy may induce changes in menstrual cycle to variable extents and even may induce amenorrhea. This study was designed to find out the effect of adjuvant chemotherapy, Doxorubicin and Cyclophosphamide, on ovarian function in patients with early stages breast cancer. Methods: Thirty premenopausal women with newly diagnosed early breast cancer enrolled in this study. In addition to a proper menstruation history, the following parameters FSH, LH, Estrogen, Progesterone, were estimated before and after 4 cycles of chemotherapy with another follow up formenstrual history after 6 months, in each patient. Results: After 4 cycles of adjuvant Doxorubicin and Cyclophosphamide chemotherapy the mean level of FSH and LH was increased and Estrogen level was decreased, significantly. While, Progesterone level was decreased non-significantly. Menstrual changes detected in most patients after receiving chemotherapy but only %47 of them developed amenorrhea which was persistent after 6 months in %33 of the patients. The induced amenorrhea has found to be related positively with the age of the patient but has no any relation with receptor status, estrogen, progesteron and Her2 (human epidermal growth factor receptor 2), of the tumor and neither with the menstrual phase at which chemotherapy has been given nor with the body mass index. Conclusions: Adjuvant chemotherapy changes ovarian hormonal levels significantly and induces transient and permanent amenorrhea in patients with early stages breast cancer.