AMENORRHEA AFTER CHEMOTHERAPY IN BREAST CANCER PATIENT

Ramchandani Ravi, Ghulam Haider, Khalil Ahmed, Abdus Sami, Saima Zahoor, Ramchandani Lata

Abstract


Background: This study was conducted to determine the frequency of amenorrhea after chemotherapy among breast cancer patients”. Methods: Total 201 premenopausal females (having menstruation during the past 6 months at the time of diagnosis) of age 15–45 years and had confirmed diagnosis of breast cancer requiring chemotherapy were included in the study using non-probability consecutive sampling technique. Amenorrhea within 6 months after the completion of chemotherapy was labelled as chemotherapy induced amenorrhea. Data was entered and analysed using SPSS-23. Results: The mean age of the patients was reported as 37.06±5.68 years. Majority of the females were married (86.6%) & multigravida (81.1%). Most of the patients (23.9%) received neoadjuvant chemotherapy followed by surgery and radiotherapy. A total of 129 patients received Adriamycin plus cyclophosphamide followed by paclitaxel as chemotherapy regimen. Out of 201 females, 184 (91.5%) experienced amenorrhea after start or completion of chemotherapy. Conclusion: The frequency of CIA was very high among breast cancer patients in our study, long term follow-up is needed to see input of CIA on future fertility.

Keywords: Chemotherapy; amenorrhea; breast cancer; chemotherapy induced amenorrhea


Full Text:

PDF

References


Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005;55(2):74–108.

Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin 2017;67(1):7–30.

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136(5):E359–86.

Meng K, Tian W, Zhou M, Chen H, Deng Y. Impact of chemotherapy-induced amenorrhea in breast cancer patients: the evaluation of ovarian function by menstrual history and hormonal levels. World J Surg Oncol 2013;11:101.

Perez-Fidalgo JA, Rosello S, Garcia-Garre E, Jorda E, Martin-Martorell P, Bermejo B, et al. Incidence of chemotherapy-induced amenorrhea in hormone-sensitive breast cancer patients: the impact of addition of taxanes to anthracycline-based regimens. Breast Cancer Res Treat 2010;120(1):245–51.

Pourali L, Taghizadeh Kermani A, Ghavamnasiri MR, Khoshroo F, Hosseini S, Asadi M, et al. Incidence of chemotherapy-induced amenorrhea after adjuvant chemotherapy with taxane and anthracyclines in young patients with breast cancer. Iran J Cancer Prev 2013;6(3):147–50.

Shapiro CL, Recht A. Side effects of adjuvant treatment of breast cancer. N Engl J Med 2001;344(26):1997–2008.

Di Cosimo S, Alimonti A, Ferretti G, Sperduti I, Carlini P, Papaldo P, et al. Incidence of chemotherapy-induced amenorrhea depending on the timing of treatment by menstrual cycle phase in women with early breast cancer. Ann Oncol 2004;15(7):1065–71.

Jeon SJ, Lee JI, Jeon MJ, Lee M. Prognostic Effects of Adjuvant Chemotherapy-Induced Amenorrhea and Subsequent Resumption of Menstruation for Premenopausal Breast Cancer Patients. Medicine (Baltimore) 2016;95(14):e3301.

Tiong V, Rozita AM, Taib NA, Yip CH, Ng CH. Incidence of chemotherapy-induced ovarian failure in premenopausal women undergoing chemotherapy for breast cancer. World J Surg 2014;38(9):2288–96.

Fornier MN, Modi S, Panageas KS, Norton L, Hudis C. Incidence of chemotherapy-induced, long-term amenorrhea in patients with breast carcinoma age 40 years and younger after adjuvant anthracycline and taxane. Cancer 2005;104(8):1575–9.

Lee S, Kil WJ, Chun M, Jung YS, Kang SY, Kang SH, et al. Chemotherapy-related amenorrhea in premenopausal women with breast cancer. Menopause 2009;16(1):98–103.

Zhou W, Ding Q, Liang X, He Z, Zha X, Liu X, et al. The risk of amenorrhea is related to chemotherapy-induced leucopenia in breast cancer patients receiving epirubicin and taxane based chemotherapy. PloS One 2012;7(5):e37249

Zhou WB, Yin H, Liu XA, Zha XM, Chen L, Dai JC, et al. Incidence of chemotherapy-induced amenorrhea associated with epirubicin, docetaxel and navelbine in younger breast cancer patients. BMC Cancer 2010;10:281

Jacobson MH, Mertens AC, Spencer JB, Manatunga AK, Howards PP. Menses resumption after cancer treatment-induced amenorrhea occurs early or not at all. Fertil Steril 2016;105(3):765–72.e4.

Han HS, Ro J, Lee KS, Nam BH, Seo JA, Lee DH, et al. Analysis of chemotherapy-induced amenorrhea rates by three different anthracycline and taxane containing regimens for early breast cancer. Breast Cancer Res Treat 2009;115(2):335–42.

Abusief ME, Missmer SA, Ginsburg ES, Weeks JC, Partridge AH. The effects of paclitaxel, dose density, and trastuzumab on treatment-related amenorrhea in premenopausal women with breast cancer. Cancer 2010;116(4):791–8.

Letourneau JM, Ebbel EE, Katz PP, Oktay KH, McCulloch CE, Ai WZ, et al. Acute ovarian failure underestimates age-specific reproductive impairment for young women undergoing chemotherapy for cancer. Cancer 2012;118(7):1933–9.

Goldhirsch A, Gelber RD, Castiglione M. The magnitude of endocrine effects of adjuvant chemotherapy for premenopausal breast cancer patients. The International Breast Cancer Study Group. Ann Oncol 1990;1(3):183–8.

Ketkaew C, Thepsuwan K, Kiatying-Angsule N. Chemotherapy utilization of breast cancer in cancer center, Thailand. Int J Pharm 2014;4(2):28–32.

Anjum F, Razvi N, Saeed U. Effects of Chemotherapy in Breast Cancer Patients. Management 2017;4:7


Refbacks

  • There are currently no refbacks.


Contact Number: +92-992-382571

email: [jamc] [@] [ayubmed.edu.pk]