title: Chemotherapy-induced amenorrhea in patients with breast cancer with a BRCA1 or BRCA2 mutation.
abstract: OBJECTIVE
  To determine the likelihood of long-term amenorrhea after treatment with chemotherapy in women with breast cancer who carry a BRCA1 or BRCA2 mutation.
  
  
  METHODS
  We conducted a multicenter survey of 1,954 young women with a BRCA1 or BRCA2 mutation who were treated for breast cancer. We included premenopausal women who were diagnosed with invasive breast cancer between 26 and 47 years of age. We determined the age of onset of amenorrhea after breast cancer for women who were and were not treated with chemotherapy, alone or with tamoxifen. We considered chemotherapy-induced amenorrhea to have occurred when the patient experienced ≥ 2 years of amenorrhea, commencing within 2 years of initiating chemotherapy, with no resumption of menses.
  
  
  RESULTS
  Of the 1,426 women who received chemotherapy, 35% experienced long-term amenorrhea. Of the 528 women who did not receive chemotherapy, 5.3% developed long-term amenorrhea. The probabilities of chemotherapy-induced amenorrhea were 7.2% for women diagnosed before age 30 years, 33% for women age 31 to 44 years, and 79% for women diagnosed after age 45 years (P trend < .001). The probability of induced amenorrhea was higher for women who received tamoxifen than for those who did not (52% v 29%; P < .001).
  
  
  CONCLUSIONS
  Age at treatment and use of tamoxifen are important predictors of chemotherapy-induced amenorrhea in women who carry a BRCA1 or BRCA2 mutation. The risk of induced long-term amenorrhea does not seem to be greater among mutation carriers than among women who do not carry a mutation.
authors: Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
authors: Adriana
authors: A
authors: Valentini
authors: Amy
authors: A
authors: Finch
authors: Jan
authors: J
authors: Lubinski
authors: Tomasz
authors: T
authors: Byrski
authors: Parviz
authors: P
authors: Ghadirian
authors: Charmaine
authors: C
authors: Kim-Sing
authors: Henry T
authors: HT
authors: Lynch
authors: Peter J
authors: PJ
authors: Ainsworth
authors: Susan L
authors: SL
authors: Neuhausen
authors: Ellen
authors: E
authors: Greenblatt
authors: Christian
authors: C
authors: Singer
authors: Ping
authors: P
authors: Sun
authors: Steven A
authors: SA
authors: Narod
mesh_terms: D000328:Adult; D000367:Age Factors; D000568:Amenorrhea / Q000139:chemically induced / Q000235:genetics*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics*; D003625:Data Collection; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D006801:Humans; D008875:Middle Aged; D009154:Mutation; D013629:Tamoxifen / Q000009:adverse effects
chemical_list: D013629:Tamoxifen
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