Optimal endocrine therapy for breast cancer patients in different age groups with chemotherapy-induced amenorrhea

Abstract

Objective To assess the incidence of ovarian function recovery (OFR) in women with breast cancer who were premenopausal at diagnosis and who underwent chemotherapy-induced amenorrhea (CIA) during treatment, and to explore the optimal endocrine therapy for breast cancer patients in different age groups with CIA. Methods The data of one hundred and twenty-three women from January 2012 to December 2015 diagnosed with breast cancer at the First Affiliated Hospital of Sun Yat-sen University was analyzed retrospectively. The patients were divided into ≤40 years (n=35), >40 years and ≤45 years (n=34) and >45 years (n=54) subgroups. A general linear model was used to assess incidences of OFR by agesubgroups. Results 26 patients (74.29%) developed CIA in ≤40 years group. Of these, 29 patinets (82.86%) regained ovarian function within 2 years; 100% of patients in >40 to 45 years and >45 years groups developedCIA, and 17 (50.00%) and 3 (5.56%) of these regained ovarian function within 2 years, and this was significantly lower in those who were elder (χ2=24.42, 54.97, both P<0.01). In this retrospective study, 19 patients of median age 51.08 years (48.00 to 54.25 years) with hormone receptor positive high-risk breast cancer who had median 9 months (2 to 21 months) of CIA were treated with aromatase inhibitor (AI). None regained ovarian function with a median of 32 months (8 to 68 months) follow-up. Conclusions For breast cancer patients with CIA age ≤45, AI should be avoided due to the high risk of OFR. For breast cancer patients age ≥51 who have at least 9 months of CIA, AI can be chosen with monitoring ovarian function regularly. Key words: Breast neoplasms; Amenorrhea; Chemotherapy-induced; Ovarian function tests; Aromatase; Enzyme inhibitors