P2-12-24: Resumption or Persistence of Menstruation after Cytotoxic Chemotherapy Is a Poor Prognostic Factor for Disease Free Survival in Premenopausal Patients with Early Breast Cancer.

Abstract

Abstract Background : We investigated the relationship between resumption or persistence of menstruation after chemotherapy and disease free survival (DFS) in premenopausal patients with early breast cancer. Patients and methods : A total of 843 patients diagnosed with a stage I to III breast cancer between March 2001 and December 2006 were included in this study. All patients received cytotoxic chemotherapy after surgery; 411 (48.8%) with anthracycline based, 416 (49.3%) with anthracycline and taxane containing, and 16 (1.9%) with other regimens. We reviewed the medical records with a long term follow-up. Results : The median age of patients was 41 years (range, 21–54 years) and the median follow-up duration was 6.2 years (range, 0.7−10.4 years). Of all, 632 (75%) patients were hormone receptor (HR) positive who received tamoxifen therapy upon completion of chemotherapy. The chemotherapy induced amenorrhea (CIA) rate was 78.1% (n=658) and 52.4% (n= 442) experienced the resumption of period during the long term follow-up. One hundred two (12.1%) patients had persistent menstruation without CIA. The disease free survival (DFS) was significantly affected by the younger age (≤ 35 years) (HR=1.58, [95% CI, 1.10−2.70], P=0.014), advanced stage (stage 3) (HR=4.45, [95% CI, 3.17−6.25], P<0.001), HR negativity (HR=2.21, [95% CI, 1.57−3.12], P<0.001), HER2 positivity (HR=1.56, [95% CI, 1.04−2.34], P=0.032), and the resumption or persistent period (HR=2.03, [95% CI, 1.42−2.91], P<0.001). HR negativity (HR=2.03, [95% CI, 1.43−2.90], P<0.001), advanced stage (HR=4.40, [95% CI, 3.12−6.21], P<0.001), and the resumed or persistent period (HR=1.85, [95% CI, 1.24−2.77], P=0.002) were remained significant factors for DFS on multivariate analysis. Conclusions : A considerable proportion of premenopausal patients treated by chemotherapy experienced resuming period after CIA. The resumption or persistence of menstruation was a poor prognostic factor for disease free survival in premenopausal patients with early breast cancer. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-12-24.