Chemotherapy-induced amenorrhea and the resumption of menstruation in premenopausal women with hormone receptor-positive early breast cancer

• Published in: Breast cancer (Tokyo, Japan) Vol. 24; no. 5; pp. 714 - 719
• Main Authors: Koga, Chinami, Akiyoshi, Sayuri, Ishida, Mayumi, Nakamura, Yoshiaki, Ohno, Shinji, Tokunaga, Eriko
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.09.2017; Springer
• Subjects: Adjuvant treatment; Adult; Age Factors; Amenorrhea; Amenorrhea - chemically induced; Amenorrhea - epidemiology; Analysis; Anthracyclines; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Cancer; Cancer Research; Chemotherapy, Adjuvant - adverse effects; Chemotherapy, Adjuvant - methods; Female; Health aspects; Hormones; Humans; Incidence; Medicine; Medicine & Public Health; Menopause; Menstruation; Menstruation - drug effects; Middle Aged; Neoadjuvant Therapy - adverse effects; Neoadjuvant Therapy - methods; Oncology; Original Article; Ovary - drug effects; Ovary - metabolism; Premenopause - drug effects; Receptors, Estrogen - metabolism; Receptors, Progesterone - metabolism; Surgery; Surgical Oncology; Time Factors; Women; Young Adult; Hormone receptor; Breast cancer; Premenopausal women; Resumption of menstruation; Chemotherapy-induced amenorrhea
• ISSN: 1340-6868; 1880-4233
• DOI: 10.1007/s12282-017-0764-1

Background For premenopausal women with breast cancer, information on the effects of chemotherapy and the risk of infertility is important. In this study, the effect of chemotherapy on the ovarian function in premenopausal women with hormone receptor-positive breast cancer was investigated, with an age-stratified analysis of the appearance of amenorrhea and the resumption of menstruation after the use of chemotherapy with anthracyclines or taxanes. Patients and methods Premenopausal women diagnosed with operable Stage I–III hormone receptor-positive breast cancer and underwent neoadjuvant or adjuvant chemotherapy with the standard regimen of anthracyclines and/or taxanes were included. The patients were classified into age groups in 5-year increments, and the rates of chemotherapy-induced amenorrhea (CIA), resumption of menstruation, and duration of CIA after chemotherapy were analyzed. Results The subjects consisted of 101 patients (median age 45 years). CIA occurred in 97 (96%) patients and 40 patients resumed menstruation. In all patients aged ≤39 years menstruation restarted, whereas in all patients aged ≥50 years, menstruation did not restart. For the patients who resumed menstruation, the younger the patients, the sooner menstruation tended to restart. The resumption of menstruation occurred within 1 year for younger patients aged around 30 years, but for those aged ≥35 years, 60% of cases took around 2–3 years for resumption. Conclusions The incidence of CIA, the resumption of menstruation and duration of CIA after chemotherapy depend greatly on the patient’s age.