Analysis Of Chemotherapy-Induced Amenorrhea Via Tests Of Serum Hormone Levels In Chinese Breast Cancer Patients

Background:The majority of newly-diagnosed breast cancers in China are premenopausal patients. We evaluated menstrual history transition by monitoring levels of serum estradiol (E2) and follicle-stimulating hormone (FSH) in premenopausal breast cancer patients to identify their actual menstrual statuses as a base of choice for endocrine therapy.Patients and Methods:We retrospectively analyzed menstrual statuses and serum E2and FSH levels in68premenopausal breast cancer patients who underwent standard adjuvant chemotherapy. Relations between menstrual statuses, hormone levels, and changes in menstrual history were assessed. Proportions were compared using Fisher’s exact tests and chi-square tests to determine the relationship with CIA. One-way analysis of variance (ANOVA) was performed to examine difference of amenorrhea duration and menopause occurred time.Results:Fifty-six women (82.3%) developed CIA after initial cytotoxic therapy. Age was a major predictor for chemotherapy-induced amenorrhea (CIA), menstrual resumption and menopause. The onset of CIA was more frequent in patients over age45. Ovarian function was commonly reversible in not more than45years old patients (P=0.0064), median time of reverse menstruation after amenorrhea was7months.32.4%patients’E2and FSH levels reached the range of postmenopause after CIA in follow-up, and tamoxifen increased risk of menopause regardless of age (P=0.0262).10.3%patients were persisting amenorrhea, but the serum hormone statuses were still under premenopausal levels.16patients did not have biochemical confirmation of ovarian function resumption concomitant with vaginal bleeding.Conclusion:In conclusion, breast cancer patients over age45should not receive an AI except for those who undergo ovarian suppression simultaneously. Close surveillance of serum E2and FSH levels is consumingly suggested for amenorrheic women over age45.