title: Determinants of recovery from amenorrhea in premenopausal breast cancer patients receiving adjuvant chemotherapy in the taxane era.
abstract: Chemotherapy-induced amenorrhea occurs in about 20-70% of premenopausal breast cancer patients. Chemotherapy-induced amenorrhea can affect choice of hormonal therapy, fertility, and quality of life of breast cancer survivors. We retrospectively analyzed the incidence of amenorrhea after adjuvant chemotherapy and the subsequent recovery of the menses in 145 breast cancer patients. Age, smoking, alcohol consumption, body mass index, chemotherapy regimen, previous hormonal therapies, and previous childbearing were analyzed as potential predictive factors of ovarian function recovery. Median age was 42 years at the beginning of adjuvant chemotherapy with 30.3% of patients below 40 years of age. The majority (87.6%) of patients received anthracycline-based chemotherapy, 35.2% of patients received a cyclophosphamide-methotrexate-5-fluorouracil regimen and 42.8% received a taxane. The incidence of chemotherapy-induced amenorrhea was 80, and 35.3% of these patients resumed menses after a median of 8 months. In multivariate analysis, younger age (<40 years, P=0.01) and taxane-based chemotherapy (P=0.03) were associated with increased probability of recovery of menses after chemotherapy-induced amenorrhea. In contrast, cyclophosphamide-methotrexate-5-fluorouracil-based chemotherapy (P=0.07) and previous childbearing (P=0.04) were associated with an increased probability of permanent chemotherapy-induced amenorrhea. Recovery of menses after chemotherapy-induced amenorrhea occurs more probably in younger women, with no pregnancies and receiving taxanes.
authors.affiliation: Department of Medical Oncology, University Hospital of Udine, Udine, Italy. minisini.alessandro@aoud.sanita.fvg.it
authors.forename: Alessandro Marco
authors.initials: AM
authors.lastname: Minisini
authors.forename: Jessica
authors.initials: J
authors.lastname: Menis
authors.forename: Francesca
authors.initials: F
authors.lastname: Valent
authors.forename: Claudia
authors.initials: C
authors.lastname: Andreetta
authors.forename: Barbara
authors.initials: B
authors.lastname: Alessi
authors.forename: Gaetano
authors.initials: G
authors.lastname: Pascoletti
authors.forename: Andrea
authors.initials: A
authors.lastname: Piga
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Fasola
authors.forename: Fabio
authors.initials: F
authors.lastname: Puglisi