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


METHODS
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 amenorrhea. 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).


CONCLUSIONS
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.
Department of Radiation oncology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
Whoon Jong
WJ
Kil
Seung Do
SD
Ahn
Seong Soo
SS
Shin
Sang-Wook
SW
Lee
Eun Kyung
EK
Choi
Jong Hoon
JH
Kim
Byung Ho
BH
Son
Sei-Hyun
SH
Ahn
Woo Kun
WK
Kim
Sung Bae
SB
Kim
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008598:Menstruation / Q000187:drug effects*; D012189:Retrospective Studies; D017211:Treatment Failure