Amenorrhea, fertility preservation, and counseling among young women treated with anthracyclines and taxanes for early-stage breast cancer, a retrospective study

Abstract

Chemotherapy may cause ovarian toxicity and infertility. Cancer patients are usually overwhelmed, and focus exclusively on cancer diagnosis and may not pay attention to fertility-related issues. In this paper we look at the rate of amenorrhea and fertility counseling among such young patients. Premenopausal women with early-stage breast cancer treated with adjuvant or neoadjuvant chemotherapy were recruited. Amenorrhea was defined as absence of menstruation for ≥12 months after the completion of chemotherapy. A total of 94 patients met the eligibility criteria and were included in this analysis. Median age at diagnosis was 35.7 (range, 22–44) years. Seventy-nine (85.9%) respondents were counseled about amenorrhea and 37 (40.2%) were considering having children. Long-term amenorrhea was reported by 51 (54.3%) patients. The addition of taxanes to anthracyclines, in 2 different regimens, increased the risk of amenorrhea to 69.2% and 66.7% compared to 38.9% with anthracycline-alone, P < .0001. Longer duration of chemotherapy (≥24 weeks) might also be associated with higher rate of amenorrhea (67.7%) compared to 43.4% in those who had shorter duration (<24 weeks), P = .031. The addition of taxanes to anthracycline-based chemotherapy increased the risk of amenorrhea. However, shorter duration of chemotherapy, even with taxanes, may lower such risk. Our study highlights the importance of fertility counseling to improve fertility preservation rates. Given the importance of taxanes, shorter regimens are associated with lower amenorrhea rates and should be preferred over longer ones.

Chemotherapy-Induced Amenorrhea and Its Prognostic Significance in Premenopausal Women With Breast Cancer: An Updated Meta-Analysis

“…The full text of the 298 studies was reviewed thoroughly, and 230 articles were excluded because of (1) not meeting inclusion and exclusion criteria (patient characteristics, insufficient information to measure outcomes) (n = 199); (2) case report or animal experiments (n = 14); (3) reviews, editorials, and letters (n = 2); (4) duplicate reports (n = 10); and (5) small samples (n = 5). Ultimately, 68 studies ( 6 , 10 – 15 , 19 , 20 , 22 , 26 – 83 ) met all inclusion criteria and were included in this meta-analysis. The flowchart of the literature search is shown in Figure 1 .…”

On Becoming a Mother After Cancer Survival: A Comprehensive Literature Review

“…The desire for motherhood is one of the top priorities for most young female cancer survivors [6]. according to recent studies, 75% of women between 18 and 45 years old with a diagnosis of cancer wish to have children [7].…”