Chemotherapy-Induced Amenorrhea from Adjuvant Breast Cancer Treatment: The Effect of the Addition of Taxanes

Davis, Abigail; Klitus, M.; Mintzer, David M.

doi:10.3816/cbc.2005.n.046

Cited by 50 publications

(32 citation statements)

References 9 publications

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“…25 Neither the addition of taxane to the anthracycline-based regimen nor BMI influenced the rate of permanent amenorrhea in our study. However, many previous studies have suggested a higher rate with the addition of taxane, 16,26 whereas others reported that rates may be lower or equivalent 17,18,27 to ours. In general, CRA rates with CMF are higher than those with the anthracycline-based regimen.…”

Section: Factors Associated With Permanent Cracontrasting

confidence: 45%

Chemotherapy-related amenorrhea in premenopausalwomen with breast cancer

et al. 2009

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Objective: To report the incidence of chemotherapy-related amenorrhea (CRA) from chemotherapy with/ without adjuvant endocrine therapy in premenopausal women with breast cancer and to analyze the related factors.Design: From January 2000 to August 2006, 326 premenopausal women (e50 y old) who completed chemotherapy were available for analysis. The CRA definitional criterion in this study was no menstruation for 6 months in a woman who was premenopausal at diagnosis. As risk factors for CRA, woman's age, the type of chemotherapy regimen, adjuvant endocrine therapy use, and body mass index were evaluated.Results: The median age was 42 years (range, 22-50 y). The median follow-up period was 37 months (range, 12-80 mo). Women were divided into two groups by age at diagnosis: 128 women in group 1 (less than 40 years old) and 198 women in group 2 (age Q40 y). CRA occurred in a total of 223 (68%) women: 43% in group 1 and 85% in group 2 (P G 0.001). Despite CRA, 14% resumed menstruation: 24% in group 1 and 11% in group 2. Another 40 (12%) women had less than 6 months of menstruation interruption. Permanent CRA was related with age at diagnosis and use of adjuvant endocrine therapy (P G 0.05). In this study, there were four pregnancies, two of which resulted in therapeutic abortion due to ongoing chemotherapy.Conclusions: This study confirmed that the rate of CRA depends on age at diagnosis and the use of adjuvant endocrine therapy. It is essential to inform young women of reproductive age of the possibility of amenorrhea or resumption of menstruation and contraceptive options.

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Section: Factors Associated With Permanent Cracontrasting

confidence: 45%

Chemotherapy-related amenorrhea in premenopausalwomen with breast cancer

et al. 2009

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“…Transient and prolonged amenorrhea was more frequent with CMF-and CEF/CAF-type regimens compared with AC (Bines et al 1996), presumably due to a higher cumulative dose of cyclophosphamide received. Addition of taxanes has shown to increase the risk of CIA, particularly in the first year, in many (Martin et al 2005, Tham et al 2007, Han et al 2009, Swain et al 2009, Najafi et al 2011 but not in all trials (Davis et al 2005, Fornier et al 2005, Berliere et al 2008, Perez-Fidalgo et al 2010, Zhou et al 2010. However, comparison of rates of CIA across different studies is limited by considerable differences in treatments used, median age of patients, prevalence of endocrine-responsive disease, follow-up duration, and variability in the definition of CIA (from 3 months to O1 year absence of menses).…”

Section: R23mentioning

confidence: 99%

Recognizing menopause in women with amenorrhea induced by cytotoxic chemotherapy for endocrine-responsive early breast cancer

Torino¹,

Barnabei²,

Vecchis³

et al. 2012

Endocrine-Related Cancer

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Cytotoxic anticancer treatment may induce amenorrhea or menopause to a variable extent. These side effects may not only impair or impede fertility but also cause sexual dysfunction, bone loss, and menopausal symptoms, with a strikingly negative effect on quality of life in many women. Aromatase inhibitors (AIs) are a recommended adjuvant endocrine treatment option in postmenopausal patients affected by early breast cancer (EBC) but are contraindicated in premenopausal women and in those with residual ovarian function. Women over 40 years of age with chemotherapy-induced amenorrhea (CIA) and routine hormonal levels consistent with menopause may receive an AI as adjuvant endocrine treatment. For these women, the tools available to identify menopause do not appear to be completely reliable. This review focused on the pathophysiology of ovarian toxicity induced by cytotoxic agents and on potentially useful methods to diagnose chemotherapy-induced menopause in patients treated with adjuvant chemotherapy for endocrine-responsive EBC. Moreover, practical approaches are proposed to distinguish true menopausal women, who would benefit from AIs, from those with transient or persistent CIA.

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“…The evidence for the potential gonadotoxicity taxanes may confer limited and inconsistent. Few clinical studies have found no additional increase in amenorrhea rates in women treated by taxanecontaining regimens, or a mild increase in a reversible amenorrhea (Davis et al 2005, Berliere et al 2008, Reh et al 2008, Abusief et al 2010, Pérez-Fidalgo et al 2010. Nevertheless, several prospective studies have shown that the incidence of amenorrhea in taxanebased chemotherapy regimens was higher than in anthracycline-based chemotherapy regimens (Fornier et al 2005, Oktay et al 2005, Han et al 2009).…”

Section: Taxanesmentioning

confidence: 99%

What lies behind chemotherapy-induced ovarian toxicity?

Ben‐Aharon

Shalgi

2012

Reproduction

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Seminal advances in anticancer therapy as well as supportive care strategies have led to improved survival rates, posing an emphasis on preserving an optimum quality of life after cancer treatment. This recognition has paved the way to an increasing research of long-term side effects, both clinical and preclinical and to an ongoing design of a supportive care system to evaluate and treat long-term adverse effects of anticancer treatments, including the impact on fertility. As with many adverse effects induced by anticancer treatments, the literature comprised mostly clinical data with regard to chemotherapy-induced gonadotoxicity, while understanding of the biological mechanism is lagging. The impact of anticancer treatments on female fertility depends on the women's age at the time of treatment, the chemotherapy protocol, the duration, and total cumulative dose administered. Several suggested mechanisms that underlie chemotherapy-induced gonadotoxicity have been described. This review illustrates the clinical evidence, as well as its supportive preclinical studies, while proceeding from the 'bedside to the bench work' and provides an insight to what lies behind chemotherapyinduced gonadotoxicity.

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Chemotherapy-Induced Amenorrhea from Adjuvant Breast Cancer Treatment: The Effect of the Addition of Taxanes

Cited by 50 publications

References 9 publications

Chemotherapy-related amenorrhea in premenopausalwomen with breast cancer

Chemotherapy-related amenorrhea in premenopausalwomen with breast cancer

Recognizing menopause in women with amenorrhea induced by cytotoxic chemotherapy for endocrine-responsive early breast cancer

What lies behind chemotherapy-induced ovarian toxicity?

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