Abstract
Objective: To evaluate the prevalence and potential factors related to irreversible chemotherapy-induced amenorrhea (CIA) in premenopausal women with breast cancer. Methods: First diagnosis breast cancer women in Stages I-III who had menstruation within three months before receiving chemotherapy and completed a course of treatment were interviewed about the menstrual cycle after a complete course of chemotherapy and the subsequent menstrual status. Clinical data were retrospectively reviewed. Age at starting chemotherapy was calculated for an optimal cut-off point by using the receiver operating characteristic curve to predict irreversible CIA. The clinicopathological variables were compared using univariate and multivariate analysis to identify the independent factors related to irreversible CIA. Results: One hundred and fifty-four premenopausal breast cancer women who met the inclusion criteria were interviewed. They were treated with chemotherapy between October 1999 and September 2018. The median age at the start of treatment was 43.5 years. One hundred forty-two patients (92.2%) developed CIA and 37 cases subsequently resumed menstruation (RM). Thus, the prevalence of irreversible CIA was 68.2%. The group > 45 years of age, estrogen receptor-positive, progesterone receptor-positive and maintenance treatment with tamoxifen significantly developed irreversible CIA in univariate analysis. However, only the > 45-year-old group was an independent factor for the CIA with an adjusted odds ratio of 23.04. Conclusion: Nearly 70% of premenopausal breast cancer women developed irreversible CIA and the independent factor for this event was being older than 45-years-old when receiving chemotherapy.
Highlights
Breast cancer is the most common female cancer in the world with the age-standardized incidence rate (ASR) and mortality rate as high as 46.3 and 13.0 per 100,000 persons-year, respectively
The principle treatment of breast cancer included surgery followed by adjuvant chemotherapy, radiotherapy or hormonal therapy depending on the stage and the specific receptors [2]
All newly diagnosed stage I-III breast cancer patients treated between October 1999 and September 2018 who had regular menstruation with the last menstrual period occurring within three months before starting chemotherapy and free of disease more than 12 months after a complete course of chemotherapy were invited to participate in this study
Summary
Breast cancer is the most common female cancer in the world with the age-standardized incidence rate (ASR) and mortality rate as high as 46.3 and 13.0 per 100,000 persons-year, respectively. Globocan 2018 reported ASR of breast cancer women younger than 45 years-old as 13.4 per 100,000 people per year [1] In this age group, the cytotoxic chemotherapy used as adjuvant drugs for treating breast cancer such as doxorubicin, cyclophosphamide, docetaxel, paclitaxel, methotrexate, and 5-fluorouracil affected the ovarian function by destroying and eliminating the primordial follicles and subsequently induced transient or permanent amenorrhea [3]. The cytotoxic chemotherapy used as adjuvant drugs for treating breast cancer such as doxorubicin, cyclophosphamide, docetaxel, paclitaxel, methotrexate, and 5-fluorouracil affected the ovarian function by destroying and eliminating the primordial follicles and subsequently induced transient or permanent amenorrhea [3] These effects may result in physiological changes associated with menopausal problems like osteoporosis, hypercholesterolemia, hot flushes, genitourinary symptom, psychologic stress, weight gain and infertility [4]. Due to the prohibition for giving hormonal therapy to breast cancer survivors, the resuming of menstruation after discontinued chemotherapy is very important to reduce
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
