I H Park1, H S Han2, H Lee3, K S Lee1, H S Kang1, S Lee1, S W Kim1, S Jung1, J Ro4. 1. Center for Breast Cancer, National Cancer Center, Goyang. 2. Department of Internal medicine, Chungbuk College of Medicine, Chungbuk. 3. Center for Clinical Trial, National Cancer Center, Goyang, Korea. 4. Center for Breast Cancer, National Cancer Center, Goyang. Electronic address: jungsro@ncc.re.kr.
Abstract
BACKGROUND: We investigated the relationship between resumption or persistence of menstruation after cytotoxic chemotherapy (RM) and disease-free survival (DFS) in premenopausal patients with early breast cancer. METHODS: Medical records from 872 patients who received cytotoxic chemotherapy for stage I to III breast cancer were retrospectively reviewed. RESULTS: The median patient age was 41 years (range, 21-54) and the median follow-up duration was 6.2 years (range, 0.7-10.4). Six hundred ninety-two patients (79.4%) were hormone receptor (HR) positive and the majority of these received tamoxifen therapy after completing chemotherapy. The chemotherapy-induced amenorrhea (CIA) rate was 76.7% (n = 669), and 51.8% (n = 452) experienced RM during the follow-up period. One hundred twenty-one (13.9%) patients had persistent menstruation without CIA. DFS was significantly affected by younger age at diagnosis (≤35 years) (P = 0.013), tumor size > 2 cm (P < 0.001), node positivity (P < 0.001), HR negativity (P < 0.001), HER2 positivity (P = 0.010), and RM (P < 0.001). HR negativity [hazard ratio 1.7, 95% confidence interval (CI) 1.2-2.4, P = 0.006], tumor size > 2 cm (hazard ratio 2.1, 95% CI 1.4-3.0, P < 0.001), node positivity (hazard ratio 3.0, 95% CI 2.0-4.7, P < 0.001), and RM (hazard ratio 1.8, 95% CI 1.2-2.7, P = 0.004) remained significant factors for DFS on multivariate analysis. CONCLUSIONS: A considerable proportion of premenopausal patients treated with chemotherapy experienced RM after CIA. RM was a poor prognostic factor for DFS in premenopausal patients with early breast cancer.
BACKGROUND: We investigated the relationship between resumption or persistence of menstruation after cytotoxic chemotherapy (RM) and disease-free survival (DFS) in premenopausal patients with early breast cancer. METHODS: Medical records from 872 patients who received cytotoxic chemotherapy for stage I to III breast cancer were retrospectively reviewed. RESULTS: The median patient age was 41 years (range, 21-54) and the median follow-up duration was 6.2 years (range, 0.7-10.4). Six hundred ninety-two patients (79.4%) were hormone receptor (HR) positive and the majority of these received tamoxifen therapy after completing chemotherapy. The chemotherapy-induced amenorrhea (CIA) rate was 76.7% (n = 669), and 51.8% (n = 452) experienced RM during the follow-up period. One hundred twenty-one (13.9%) patients had persistent menstruation without CIA. DFS was significantly affected by younger age at diagnosis (≤35 years) (P = 0.013), tumor size > 2 cm (P < 0.001), node positivity (P < 0.001), HR negativity (P < 0.001), HER2 positivity (P = 0.010), and RM (P < 0.001). HR negativity [hazard ratio 1.7, 95% confidence interval (CI) 1.2-2.4, P = 0.006], tumor size > 2 cm (hazard ratio 2.1, 95% CI 1.4-3.0, P < 0.001), node positivity (hazard ratio 3.0, 95% CI 2.0-4.7, P < 0.001), and RM (hazard ratio 1.8, 95% CI 1.2-2.7, P = 0.004) remained significant factors for DFS on multivariate analysis. CONCLUSIONS: A considerable proportion of premenopausal patients treated with chemotherapy experienced RM after CIA. RM was a poor prognostic factor for DFS in premenopausal patients with early breast cancer.
Authors: Melanie H Jacobson; Ann C Mertens; Jessica B Spencer; Amita K Manatunga; Penelope P Howards Journal: Fertil Steril Date: 2015-12-01 Impact factor: 7.329
Authors: Leila Pourali; Ali Taghizadeh Kermani; Mohammad Reza Ghavamnasiri; Fahimeh Khoshroo; Sare Hosseini; Mehdi Asadi; Kazem Anvari Journal: Iran J Cancer Prev Date: 2013
Authors: Mark van Barele; Bernadette A M Heemskerk-Gerritsen; Helena C van Doorn; Marjanka K Schmidt; Maartje J Hooning; Agnes Jager Journal: Breast Date: 2020-05-22 Impact factor: 4.380
Authors: Jae Jun Shin; Young Min Choi; Jong Kwan Jun; Kyung-Hun Lee; Tae-Yong Kim; Wonshik Han; Seock-Ah Im Journal: J Breast Cancer Date: 2019-11-13 Impact factor: 3.588
Authors: Arran K Turnbull; Samir Patel; Carlos Martinez-Perez; Anne Rigg; Olga Oikonomidou Journal: Breast Cancer Res Treat Date: 2020-10-12 Impact factor: 4.872