Abstract
Purpose: Chemotherapy-induced amenorrhea (CIA) by newer taxane-containing regimens was evaluated in early breast cancer (EBC) patients. Methods: A prospective cohort of 122 premenopausal EBC patients participated in a phase III trial of preoperative docetaxel/capecitabine (TX) versus doxorubicin/cyclophosphamide (AC); 34 patients received adjuvant AC followed by paclitaxel (T) and 129 patients received 5-fluorouracil/doxorubicin/cyclophosphamide (FAC). Results: The CIA rate was 90.2% with TX/AC, 73.5% with AC followed by T, and 72.1% with FAC at 1 year (P = 0.002), and 66.7%, 73.3%, and 58.9%, respectively, at 3 years (P = 0.268). At one year, age (P < 0.001) and taxane use (P = 0.002), and after two years, age and tamoxifen use were significant factors for CIA in multivariate analysis. Serum estradiol and follicle-stimulating hormone levels were significantly correlated with menstrual status, age, and tamoxifen use. Conclusion: Taxanes resulted in higher CIA rates in the first year, but age and tamoxifen use were significant factors for persistent CIA.
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Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomized trials. Lancet 365(9472):1687–1717. doi:10.1016/S0140-6736(05) 66544-0
Bines J, Oleske DM, Cobleigh MA (1996) Ovarian function in premenopausal women treated with adjuvant chemotherapy for breast cancer. J Clin Oncol 14(5):1718–1729
Shapiro CL, Recht A (2001) Side effects of adjuvant treatment of breast cancer. N Engl J Med 344(26):1997–2008. doi:10.1056/NEJM200106283442607
Walshe JM, Denduluri N, Swain SM (2006) Amenorrhea in premenopausal women after adjuvant chemotherapy for breast cancer. J Clin Oncol 24(36):5769–5779. doi:10.1200/JCO.2006.07.2793
Minton SE, Munster PN (2002) Chemotherapy-induced amenorrhea and fertility in women undergoing adjuvant treatment for breast cancer. Cancer Control 9(6):466–472
Knobf MT (2006) The influence of endocrine effects of adjuvant therapy on quality of life outcomes in younger breast cancer survivors. Oncologist 11(2):96–110. doi:10.1634/theoncologist.11-2-96
National Cancer Center Central Cancer Registry, Korea (2002) Cancer statics in Korea
Pritchard KI (2007) Risk of chemotherapy induced menopause: more detailed data will lead to improved quality of life. Eur J Cancer 43(11):1644–1645. doi:10.1016/j.ejca.2007.05.027
Goldhirsch A, Gelber RD, Castiglione M (1990) The magnitude of endocrine effects of adjuvant chemotherapy for premenopausal breast cancer patients. The International Breast Cancer Study Group. Ann Oncol 1(3):183–188
Levine MN, Pritchard KI, Bramwell VH et al (2005) Randomized trial comparing cyclophosphamide, epirubicin, and fluorouracil with cyclophosphamide, methotrexate, and fluorouracil in premenopausal women with node-positive breast cancer: update of National Cancer Institute of Canada Clinical Trials Group Trial MA5. J Clin Oncol 23(22):5166–5170. doi:10.1200/JCO.2005.09.423
Fornier MN, Modi S, Panageas KS, Norton L, Hudis C (2005) Incidence of chemotherapy-induced, long-term amenorrhea in patients with breast carcinoma age 40 years and younger after adjuvant anthracycline and taxane. Cancer 104(8):1575–1579. doi:10.1002/cncr.21385
Davis AL, Klitus M, Mintzer DM (2005) Chemotherapy-induced amenorrhea from adjuvant breast cancer treatment: the effect of the addition of taxanes. Clin Breast Cancer 6(5):421–424
Tham YL, Sexton K, Weiss H, Elledge R, Friedman LC, Kramer R (2007) The rates of chemotherapy-induced amenorrhea in patients treated with adjuvant doxorubicin and cyclophosphamide followed by a taxane. Am J Clin Oncol 30(2):126–132. doi:10.1097/01.coc.0000251398.57630.4f
Martin M, Pienkowski T, Mackey J et al (2005) Adjuvant docetaxel for node-positive breast cancer. N Engl J Med 352(22):2302–2313. doi:10.1056/NEJMoa043681
Lee KS, Ro J, Nam BH, Lee ES, Kwon Y, Kwon HS, Chung KW, Kang HS, Kim EA, Kim SW, Shin KH, Kim SK (2007) A randomized phase-III trial of docetaxel/capecitabine versus doxorubicin/cyclophosphamide as primary chemotherapy for patients with stage II/III breast cancer. Breast Cancer Res Treat. doi:10.1007/s105490079672
Petrek JA, Naughton MJ, Case LD, Paskett ED, Naftalis EZ, Singletary SE et al (2006) Incidence, time course, and determinants of menstrual bleeding after breast cancer treatment: a prospective study. J Clin Oncol 24(7):1045–1051. doi:10.1200/JCO.2005.03.3969
Kil WJ, Ahn SD, Shin SS, Lee SW, Choi EK, Kim JH et al (2006) Treatment-induced menstrual changes in very young (<35 years old) breast cancer patients. Breast Cancer Res Treat 96(3):245–250. doi:10.1007/s10549-005-9059-x
Jones SE, Savin MA, Holmes FA, O’Shaughnessy JA, Blum JL, Vukelja S et al (2006) Phase III trial comparing doxorubicin plus cyclophosphamide with docetaxel plus cyclophosphamide as adjuvant therapy for operable breast cancer. J Clin Oncol 24(34):5381–5387. doi:10.1200/JCO.2006.06.5391
Brincker H, Rose C, Rank F, Mouridsen HT et al (1987) Evidence of a castration-mediated effect of adjuvant cytotoxic chemotherapy in premenopausal breast cancer. J Clin Oncol 5(11):1771–1778
Reyno LM, Levine MN, Skingley P, Arnold A, Abu Zahra H (1992) Chemotherapy induced amenorrhoea in a randomised trial of adjuvant chemotherapy duration in breast cancer. Eur J Cancer 29A(1):21–23
Colleoni M, Gelber S, Goldhirsch A et al (2006) Tamoxifen after adjuvant chemotherapy for premenopausal women with lymph node-positive breast cancer: International Breast Cancer Study Group Trial 13-93. J Clin Oncol 24(9):1332–1341. doi:10.1200/JCO.2005.03.0783
Burger HG (1996) The endocrinology of the menopause. Maturitas 23(2):129–136. doi:10.1016/0378-5122(95) 00969-8
Bromberger JT, Assmann SF, Avis NE, Schocken M, Kravitz HM, Cordal A (2003) Persistent mood symptoms in a multiethnic community cohort of pre- and perimenopausal women. Am J Epidemiol 158(4):347–356. doi:10.1093/aje/kwg155
Samaan NA, deAsis DN Jr, Buzdar AU, Blumenschein GR (1978) Pituitary-ovarian function in breast cancer patients on adjuvant chemoimmunotherapy. Cancer 41(6):2084–2087. doi:10.1002/1097-0142(197806)41:6≤2084::AID-CNCR2820410603≥3.0.CO;2-Y
Mehta RR, Beattie CW, Das Gupta TK (1992) Endocrine profile in breast cancer patients receiving chemotherapy. Breast Cancer Res Treat 20(2):125–132. doi:10.1007/BF01834642
Gracia CR, Sammel MD, Freeman EW, Lin H, Langan E, Kapoor S et al (2005) Defining menopause status: creation of a new definition to identify the early changes of the menopausal transition. Menopause 12(2):128–135. doi:10.1097/00042192-200512020-00005
Parulekar WR, Day AG, Ottaway JA, Shepherd LE, Trudeau ME, Bramwell V et al, National Cancer Institute of Canada Clinical Trials Group (2005) National Cancer Institute of Canada Clinical Trials Group. Incidence and prognostic impact of amenorrhea during adjuvant therapy in high-risk premenopausal breast cancer: analysis of a National Cancer Institute of Canada Clinical Trials Group Study-NCIC CTG MA.5. J Clin Oncol 23(25):6002–6008. doi:10.1200/JCO.2005.07.096
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This study was supported by NCC Grant No. NCS-07-103.
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Han, HS., Ro, J., Lee, K.S. et al. Analysis of chemotherapy-induced amenorrhea rates by three different anthracycline and taxane containing regimens for early breast cancer. Breast Cancer Res Treat 115, 335–342 (2009). https://doi.org/10.1007/s10549-008-0071-9
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DOI: https://doi.org/10.1007/s10549-008-0071-9