, Volume 43, Issue 2, pp 183-190

Amenorrhea induced by adjuvant chemotherapy in early breast cancer patients: prognostic role and clinical implications

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Background: The role of amenorrhea induced by chemotherapyin premenopausal women with early breast cancer isvery controversial. Analyses by various authors of theeffect of drug-induced amenorrhea (DIA) on treatment outcomehave yielded conflicting results. In order to gaininsight into the role of DIA, we reviewedall published data addressing the issue of DIAas a prognostic factor. Methods: Computerised and manualsearches were conducted of relevant studies published from1966 to 1995. Results: Thirteen studies involving 3929patients were selected. In two papers, the prognosticrole of DIA was analysed in three andtwo different groups of patients, respectively. Overall, 16groups of patients were evaluated. With 12 groups,a higher disease free survival was observed inpatients developing DIA compared to those who didnot. This difference was statistically significant in eightgroups. Data on overall survival, reported in onlyfive studies, indicated that it was always improvedin patients who became amenorrheic. Conclusions: Available dataon the role of DIA support its importanceas a favorable prognostic factor for early breastcancer patients. However, due to the possible biasesof this type of evaluation, this result shouldbe interpreted with caution.