Recovery of menstruation after long-term chemotherapy and endocrine therapy in pre-menopausal patients with breast cancer.
BACKGROUND
A luteinizing hormone-releasing hormone (LH-RH) agonist and tamoxifen (TAM) are used in hormonal therapy following pre- and post-operative chemotherapy in pre-menopausal advanced breast cancer patients who are positive for hormone receptors. However, it remains to be clarified how often patients recover menstruation after long-term LH-RH agonist plus TAM therapy. In this study, the incidence of menstruation recovery after therapy was examined.


METHODS
The subjects included 125 pre-menopausal patients with breast cancer who were positive for hormone receptors and had undergone surgery at our institution. They were treated with four cycles of the CEF regimen and four cycles of docetaxel (Doc) before surgery as adjuvant chemotherapy. Thereafter, they were treated with an LH-RH agonist plus TAM for 24 months and followed to determine menstruation recovery.


RESULTS
Menstruation resumed in 24 cases (19.2%) after the last LH-RH agonist treatment session. It took 7.3 ± 2.8 months for the patients to recover menstruation. The rate of menstruation recovery was 42.1% in patients aged 40 or younger and 9.2% in those aged 41 or older; the difference was significant. The period until menstruation recovery tended to be longer in older patients at the end of treatment.


CONCLUSIONS
The menstruation recovery rate after therapy was higher in younger women. However, since ovarian function may be lost even in younger patients, the potential consequences of this therapy should be fully explained beforehand to patients who may wish to become pregnant.
Sakurai
Kenichi
K
Division of Breast and Endocrine Surgery, Department of Surgery, Nihon University School of Medicine, 30-1, Oyaguchi-kamimachi, Itabashi-ku, Tokyo 173-8610, Japan. ksakurai@med.nihon-u.ac.jp
Enomoto
Katsuhisa
K
Amano
Sadao
S
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D003520:Cyclophosphamide / Q000009:adverse effects; D003561:Cytarabine / Q000009:adverse effects; D015251:Epirubicin / Q000009:adverse effects; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D008598:Menstruation / Q000187:drug effects*; D008875:Middle Aged; D017697:Premenopause; D013629:Tamoxifen / Q000009:adverse effects
D003561:Cytarabine; D013629:Tamoxifen; D007987:Gonadotropin-Releasing Hormone; D015251:Epirubicin; D003520:Cyclophosphamide