Breast Cancer Research and Treatment

, Volume 96, Issue 3, pp 245–250 | Cite as

Treatment-induced menstrual changes in very young (<35 years old) breast cancer patients

  • Whoon Jong Kil
  • Seung Do Ahn
  • Seong Soo Shin
  • Sang-wook Lee
  • Eun Kyung Choi
  • Jong Hoon Kim
  • Byung Ho Son
  • Sei-Hyun Ahn
  • Woo Kun Kim
  • Sung Bae Kim
Clinical trial

Summary

Purpose

To evaluate the treatment-induced menstrual changes in very young (< 35 years old) breast cancer patients.

Methods and materials

We retrospectively examined the clinical records of 160 patients, ranging in age from 18 to 34 years old (median age, 32 years), treated between June 1992 and December 2002. One hundred twenty patients underwent mastectomy and 40 underwent breast conserving surgery. Postoperatively, 80 patients were treated with alkylating agent-based chemotherapy regimens (CMF) and 80 with anthracycline-based regimens (AD). In addition, 57 patients received adjuvant radiotherapy, and 77 received anti-estrogen therapy. Treatment-induced menstrual changes and present menstrual status were evaluated from hospital records and by one-to-one interviews. The median follow-up period was 54 months (range, 29–156 months).

Results

Treatment-induced menstrual change (amenorrhea) was occurred in 59 (36.9%) patients, 25 (31.3%) of those treated with CMF and 34 (42.5%) with AD (p=0.142). Amenorrhea occurred after a median 2 cycles of chemotherapy (range, 1–6 cycles). Menstruation resumed in 49 (83.1%) patients, 20 (80%) of those treated with CMF and 29 (85.3%) with AD (p=0.6). Median time to resumption of menstruation was median 3.5 months (range, 1–18 months) after amenorhrea. Disease recurred in 10 (16.9%) patients who experienced treatment-induced menstrual changes and in 18 (17.8%) of those who did not (p=0.89).

Conclusion

Although the overall incidence of treatment-induced menstrual change in breast cancer patients under age 35 was similar to that reported elsewhere, the rate of recovery from these change is higher. We observed no difference between CMF and AD treated patients in rates of amenorrhea or recovery from these changes.

Keywords

breast cancer treatment-induced menstrual changes very young (<35 years old) age 

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References

  1. 1.
    Anderson WF, Jatoi I, Devesa SS, Distinct breast cancer incidence and prognostic patterns in the NCI’s SEER program: suggesting a possible link between etiology and outcome Breast Cancer Res Treat 90: 127–137, 2005CrossRefPubMedGoogle Scholar
  2. 2.
    Kalantaridou SN, Davis SR, Nelson LM, Premature ovarian failure Endocrinol Metab Clin North Am 27:989–1006, 1998CrossRefPubMedGoogle Scholar
  3. 3.
    Morimoto T, Okazaki M, Endo T, Current status and goals of mammographic screening for breast cancer in Japan Breast Cancer 11:73–81, 2004CrossRefPubMedGoogle Scholar
  4. 4.
    Walker RA, Lees E, Webb MB, Dearing SJ, Breast carcinomas occurring in young women (<35 years) are different Br J Cancer 74:1796–1800, 1996CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Adami HO, Malker B, Holmberg L, Persson I, Stone B, The relation between survival and age at diagnosis in breast cancer N Engl J Med 315:559–563, 1986CrossRefPubMedGoogle Scholar
  6. 6.
    Chung M, Chang HR, Bland KI, Wanebo HJ, Younger women with breast carcinoma have a poorer prognosis than older women Cancer 77:97–103, 1996CrossRefPubMedGoogle Scholar
  7. 7.
    Kollias J, Elston CW, Ellis IO, Robertson JF, Blamey RW, Early-onset breast cancer-histopathological and prognostic considerations Br J Cancer 75:1318–1323, 1997CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    NIH Consensus Development Program: Adjuvant Therapy for Breast Cancer. National Institutes of Health Consensus Development Statement, November 1–3, 2000Google Scholar
  9. 9.
    Early Breast Cancer Trialists’ Collaborative Group: Polychemotherapy for early breast cancer: An overview of the randomised trials. Lancet 352: 930–942, 1998CrossRefGoogle Scholar
  10. 10.
    Early Breast Cancer Trialists’ Collaborative Group: Tamoxifen for early breast cancer: An overview of the randomised trials. Lancet 351: 1451–1467, 1998CrossRefGoogle Scholar
  11. 11.
    Wingo PA, Ries LA, Giovino GA, et al Annual report to the nation on the status of cancer, 1973–1996, with a special section on lung cancer and tobacco smoking J Natl Cancer Inst 91:675–690, 1999CrossRefPubMedGoogle Scholar
  12. 12.
    Goodwin PJ, Ennis M, Pritchard KI, Trudeau M, Hood N, Risk of menopause during the first year after breast cancer diagnosis J Clin Oncol 17:2365–2370, 1999CrossRefPubMedGoogle Scholar
  13. 13.
    Bines J, Oleske DM, Cobleigh MA, Ovarian function in premenopausal women treated with adjuvant chemotherapy for breast cancer J Clin Oncol 14:1718–1729, 1996CrossRefPubMedGoogle Scholar
  14. 14.
    Chapman RM, Sutcliffe SB, Malpas JS, Cytotoxic-induced ovarian failure in women with Hodgkin’s disease. I. Hormone function JAMA 242:1877–1881, 1976CrossRefGoogle Scholar
  15. 15.
    Warne GL, Fairley KF, Hobbs JB, Martin FI, Cyclophosphamide-induced ovarian failure N Engl J Med 289:1159–1162, 1973CrossRefPubMedGoogle Scholar
  16. 16.
    Koyama H, Wada T, Nishizawa Y, Iwanaga T, Aoki Y, Cyclophosphamide-induced ovarian failure and its therapeutic significance in patients with breast cancer Cancer 39:1403–1409, 1977CrossRefPubMedGoogle Scholar
  17. 17.
    Bonadonna G, Valagussa P, Adjuvant systemic therapy for resectable breast cancer J Clin Oncol 3:259–275, 1985CrossRefPubMedGoogle Scholar
  18. 18.
    Goldhirsch A, Gelber RD, Yothers G, et al Adjuvant therapy for very young women with breast cancer: need for tailored treatments J Natl Cancer Inst Monogr 30:44–51, 2001CrossRefGoogle Scholar
  19. 19.
    Nabholtz J, Pienkowski T, Mackey J, et al Phase III trial comparing TAC with FAC in the adjuvant treatment of node positive breast cancer patients: Interim analysis of the BCIRG 001 study Proc Am Soc Clin Oncol 21(abstr 141):361, 2002Google Scholar
  20. 20.
    Hortobagyi GN, Buzdar AU, Marcus CE, Smith TL, Immediate and long-term toxicity of adjuvant chemotherapy regimens containing doxorubicin in trials at M.D. Anderson Hospital and Tumor Institute NCI Monogr 1:105–109, 1986Google Scholar
  21. 21.
    Levine MN, Bramwell VH, Pritchard KI, et al Randomized trial of intensive cyclophosphamide, epirubicin, and fluorouracil chemotherapy compared with cyclophosphamide, methotrexate, and fluoruracil in premenopausal women with node-positive breast cancer: National Cancer Institute of Canada Clinical Trials Group J Clin Oncol 16:2651–2658, 1998CrossRefPubMedGoogle Scholar
  22. 22.
    Shapiro CL, Manola J, Leboff M, Ovarian failure after chemotherapy is associated with rapid bone loss in women with early stage breast cancer J Clin Oncol 19:3306–3311, 2001CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  • Whoon Jong Kil
    • 1
  • Seung Do Ahn
    • 1
  • Seong Soo Shin
    • 1
  • Sang-wook Lee
    • 1
  • Eun Kyung Choi
    • 1
  • Jong Hoon Kim
    • 1
  • Byung Ho Son
    • 2
  • Sei-Hyun Ahn
    • 2
  • Woo Kun Kim
    • 3
  • Sung Bae Kim
    • 3
  1. 1.Department of Radiation oncology, Asan Medical Center, College of MedicineUniversity of UlsanSeoulKorea
  2. 2.Department of Surgery, Asan Medical Center, College of MedicineUniversity of UlsanSeoulKorea
  3. 3.Department of Hematology Oncology, Asan Medical Center, College of MedicineUniversity of UlsanSeoulKorea

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