The Incidence of Chemotherapy-induced Amenorrhea and Recovery in Young (&lt;45-year-old) Breast Cancer Patients

Kim, Zisun; Shin, Dong-Sun; Moon, Nan-Mo; Paik, Nam-Sun; Noh, Woo-Chul

doi:10.4048/jbc.2009.12.1.20

Cited by 6 publications

(3 citation statements)

References 29 publications

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“…Third, ovarian function was assessed only one time (based on estradiol levels) at the time of randomization in the SOFT trial, within 8 months after completing chemotheapy. However, resumption of ovarian function occurs in about 60 % of women younger than 45 years of age within 2 years after completing chemotherapy [ 16 , 17 ]. We assume that patients who recently regained ovarian function may lose the chance to benefit from the addition of OFS treatment.…”

Section: Discussionmentioning

confidence: 99%

“…This might be caused by the exclusion of patients treated with CMF regimens [ 16 , 17 ]. Because most patients treated with CMF do not recover from chemotherapy-induced amenorrhea, we excluded patients who had received the CMF regimen [ 8 , 16 , 17 ]. In contrast to the CMF regimen, modern non-CMF chemotherapy regimens result in less permanent amenorrhea after treatment.…”

Section: Discussionmentioning

confidence: 99%

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The role of the addition of ovarian suppression to tamoxifen in young women with hormone-sensitive breast cancer who remain premenopausal or regain menstruation after chemotherapy (ASTRRA): study protocol for a randomized controlled trial and progress

et al. 2016

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BackgroundOvarian function suppression (OFS) has been shown to be effective as adjuvant endocrine therapy in premenopausal women with hormone receptor-positive breast cancer. However, it is currently unclear if addition of OFS to standard tamoxifen therapy after completion of adjuvant chemotherapy results in a survival benefit. In 2008, the Korean Breast Cancer Society Study Group initiated the ASTRRA randomized phase III trial to evaluate the efficacy of OFS in addition to standard tamoxifen treatment in hormone receptor-positive breast cancer patients who remain or regain premenopausal status after chemotherapy.MethodsPremenopausal women with estrogen receptor-positive breast cancer treated with definitive surgery were enrolled after completion of neoadjuvant or adjuvant chemotherapy. Ovarian function was assessed at the time of enrollment and every 6 months for 2 years by follicular-stimulating hormone levels and bleeding history. If ovarian function was confirmed as premenopausal status, the patient was randomized to receive 2 years of goserelin plus 5 years of tamoxifen treatment or 5 years of tamoxifen alone. The primary end point will be the comparison of the 5-year disease-free survival rates between the OFS and tamoxifen alone groups. Patient recruitment was finished on March 2014 with the inclusion of a total of 1483 patients. The interim analysis will be performed at the time of the observation of the 187th event.DiscussionThis study will provide evidence of the benefit of OFS plus tamoxifen compared with tamoxifen only in premenopausal patients with estrogen receptor-positive breast cancer treated with chemotherapy.Trial registrationClinicalTrials.gov Identifier NCT00912548. Registered May 31 2009. Korean Breast Cancer Society Study Group Register KBCSG005. Registered October 26 2009.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The role of the addition of ovarian suppression to tamoxifen in young women with hormone-sensitive breast cancer who remain premenopausal or regain menstruation after chemotherapy (ASTRRA): study protocol for a randomized controlled trial and progress

et al. 2016

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“…Breast cancer is the most common cancer found in women worldwide (7), and the incidence has been continuously increasing in Korea (8). Interestingly, the age distribution of breast cancer patients in Korea is quite different from that of Western countries; premenopausal breast cancer patients in Korea constitute about 60% of newly diagnosed breast cancer patients, while only 25% of all breast cancer patients are premenopausal in Western countries (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Susceptibility for breast cancer in young patients with short rare minisatellite alleles of BORIS

Yoon¹,

Kim²,

Cho³

et al. 2010

BMB Reports

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In this study, we characterized two blocks of minisatellites in the 5' upstream region of the BORIS gene (BORIS-MS1, -MS2). BORIS-MS2 was found to be polymorphic; therefore, this locus could be useful as a marker for DNA fingerprinting. We assessed the association between BORIS-MS2 and breast cancer by a case-control study with 428 controls and 793 breast cancers cases. Rare alleles in the younger group (age, ＜40) were associated with a statistically significant increased risk of breast cancer (odds ratio, 4.84; 95% confidence interval, 1.06-22.22; and P = 0.026). A statistically significant association between the short rare alleles and cancer was identified in the younger group (8.02; 1.01-63.83; P = 0.021). Kaplan-Meier estimates showed that poor prognosis was associated with patients who contained the rare alleles. Our data suggest that the short rare alleles of BORIS-MS2 could be used to identify the risk for breast cancer in young patients. [BMB reports 2010; 43(10): 698-703]

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What lies behind chemotherapy-induced amenorrhea for breast cancer patients: a meta-analysis

Zhao

Liu

Chen

et al. 2014

Breast Cancer Res Treat

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To evaluate the incidence of chemotherapy-induced amenorrhea (CIA) and its therapeutic impact in premenopausal breast cancer patients. A systematic search was performed to identify clinical studies that compared the incidence of CIA with different chemotherapy regimens and oncological outcomes with and without CIA. The fixed-effects and random-effects models were used to assess the pooled estimates. Heterogeneity and sensitivity analyses were performed to explore heterogeneity among studies and to assess the effects of study quality. A total of 15,916 premenopausal breast cancer patients from 46 studies were included. The cyclophosphamide-based regimens, taxane-based regimens, and anthracycline/epirubicin-based regimens all increased the incidence of CIA with pooled odds ratios of 2.25 (95 % CI 1.26-4.03, P = 0.006), 1.26 (95 % CI 1.11-1.43, P = 0.0003) and 1.39 (95 % CI 1.15-1.70, P = 0.0008), respectively. The three-drug combination regimens of cyclophosphamide,anthracycline/epirubicin, and taxanes (CAT/CET) caused the highest rate of CIA compared with the other three drug combinations (OR 1.41, 95 % CI 1.16-1.73, P = 0.0008). Tamoxifen therapy was also correlated with a higher incidence of CIA, with an OR of 1.48. Patients with CIA were found to exhibit better disease-free survival (DFS) and overall survival (OS) compared with patients without CIA. With respect to molecular subtype, this DFS advantage remained significant in hormone-sensitive patients (HR 0.61, 95 % CI 0.52-0.72, P < 0.00001). The current meta-analysis has demonstrated that anthracycline/epirubicin, taxanes, cyclophosphamide, and tamoxifen all contributed to elevated rates of CIA, and CIA was not merely a side effect of chemotherapy but was a better prognostic marker, particularly for ER-positive premenopausal early-stage breast cancer patients. However, this topic merits further randomized control studies to detect the associations between CIA and patient prognosis after adjusting for age, ER status, and other influential factors.

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The Incidence of Chemotherapy-induced Amenorrhea and Recovery in Young (<45-year-old) Breast Cancer Patients

Cited by 6 publications

References 29 publications

The role of the addition of ovarian suppression to tamoxifen in young women with hormone-sensitive breast cancer who remain premenopausal or regain menstruation after chemotherapy (ASTRRA): study protocol for a randomized controlled trial and progress

The role of the addition of ovarian suppression to tamoxifen in young women with hormone-sensitive breast cancer who remain premenopausal or regain menstruation after chemotherapy (ASTRRA): study protocol for a randomized controlled trial and progress

Susceptibility for breast cancer in young patients with short rare minisatellite alleles of BORIS

What lies behind chemotherapy-induced amenorrhea for breast cancer patients: a meta-analysis

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