The Effect Of Adjuvant Therapy On The Menstrual Status Of Premenopausal Breast Cancer Patients

Background:Breast cancer is one of the most common malignant tumors in Chinese women.Due to early detection and early treatment,breast cancer patients are getting a longer survive time.But adjuvant therapies have a significant influence on ovarian function in premenopausal breast cancer women.Premenopausal women undergoing adjuvant chemotherapy may develop a series of clinical symptoms of ovarian dysfunction.The influences on menstruation may be oligomenorrhea,temporary amenorrhea and permanent amenorrhea.Objective:To investigate the impacts of adjuvant therapies on menstrual status in premenopausal breast cancer patients.Methods:The data of 216 premenopausal breast cancer patients followed-up in Department of Breast Surgery in Peking Union Medical College Hospital from September 2014 to February 2015 were retrospectively analyzed.According to the types of adjuvant therapies,patients were divided into three groups:chemotherapy only,tamoxifen therapy only,and chemotherapy incorporated with tamoxifen endocrine therapy.The impacts of different adjuvant therapies on menstrual states were investigated and factors related with chemotherapy-induced amenorrhea were also explored.Results:Approximately more than half(58.3%)premenopausal breast cancer patients who received chemotherapy developed amenorrhea.The number was only 3.5%in patients who received tamoxifen,but nearly half(43.9%)developed irregular menstruation.Age,chemotherapy regimens and tamoxifen were associated with chemotherapy induced amenorrhea(CIA)(P<0.05).Age>40 years old,anthracycline-based chemotherapy and tamoxifen were associated with increased probability of CIA(P<0.05).Whether menstruation recovery or not was associated with age.Age more than 40 years old was associated with increased probability of permanent CIA(,P<0.05).Neither chemotherapy regimens nor tamoxifen use were associated with menses recovery time(P>0.05).The mean of menstrual recovery time in temporary amenorrhea patients was 8.0±2.5 months,and menstruation would not come again if the amenorrhea time was more than 12.9 months.Conclusions:Chemotherapy for breast cancer could induce amenorrhea in more than half of premenopausal breast cancer patients.Age,chemotherapy regimen and tamoxifen use are the factors that associated with amenorrhea in premenopausal breast cancer patients.Patients received tamoxifen seldom develop amenorrhea.