AMENORRHEA AFTER CHEMOTHERAPY IN BREAST CANCER PATIENT

Authors

  • Ramchandani Ravi Jinnah Postgraduate Medical Centre Karachi
  • Ghulam Haider Jinnah Postgraduate Medical Centre
  • Khalil Ahmed Jinnah Postgraduate Medical Centre
  • Abdus Sami Jinnah Postgraduate Medical Centre
  • Saima Zahoor Jinnah Postgraduate Medical Centre
  • Ramchandani Lata Peoples Medical university,Shaheed Benazirabad

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

Author Biographies

Ramchandani Ravi, Jinnah Postgraduate Medical Centre Karachi

oncology,postgraduate trainee

Ghulam Haider, Jinnah Postgraduate Medical Centre

Associate Professor,Medical Oncology

Khalil Ahmed, Jinnah Postgraduate Medical Centre

Consultant Medical Oncologist ,Medical Oncology .

Abdus Sami, Jinnah Postgraduate Medical Centre

Consultant Medical Oncologist ,Medical Oncology .

Saima Zahoor, Jinnah Postgraduate Medical Centre

Consultant Medical Oncologist ,Medical Oncology .

Ramchandani Lata, Peoples Medical university,Shaheed Benazirabad

Civil Hospital Tandoallahyar.Medical Officer

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

Published

2020-01-23

Most read articles by the same author(s)