Clinical Significance Of Adjuvant Chemotherapy-Induced Amenorrhea In Premenopausal Breast Cancer Patients

Objective:The aim of this study was to evaluate the influence of chemotherapy -induced amenorrhea (CIA) on disease-free survival in premenopausal patients with receptor-positive breast cancer treated with adjuvant chemotherapy.Methods:Retrospectively, we reviewed data from 189 premenopausal patients with localized hormone-sensitive breast cancer. These patients were treated between 2002 and 2005 at the same institution. They all underwent surgical treatment,adjuvant chemotherapy and hormonal therapy. The patients were assigned in two groups by age, and were given different types of chemotherapy regimen. Menstrual abnormalities as well as disease free survival(DFS)were recorded during and after the chemotherapy completion. Follow up duration was 36 months after chemotherapy completion for all patients.Results:189 premenopausal breast cancer patients with localized hormone- sensitive were collected. 133(70.37%) developed CIA, 21cases (15.79%) returned to normal menses and 112(84.21%) remained amenorrhea. During the follow up, DFS rate was 96.18% in CIA group and 85.0% in non-CIA group, (P< 0.05) with a statistically significant difference. The rate of CIA increased with age (P< 0.005). Patients below forty-age had a DFS rate of 47.22%, while these up forty-age had a rate of 84.21%. But there had no statistically significant difference between the patients treated with different chemotherapy-drug. DFS rate was 94.12% in CIA group and 77.27% in non-CIA group, (P< 0.05) with a statistically significant difference in patients below forty-age. But it had no statistically significant difference in patients up forty-age. Meanwhile DFS rate had no statistically significant difference between these who had castrated ovaries and CIA group. Conclusions:Adjuvant chemotherapy causes ovarian function suppression, and further leading to amenorrhea. Chemotherapy-induced amenorrhea (CIA) is related with age of patients. It may improve three-year disease-free survival (DFS) with receptor-positive premenopausal women. Our result suggests that a CIA might have its own therapeutic effect besides the cytotoxic action of chemotherapy.