In this study; Amenorrhea caused by chemotherapy in early stage breast cancer patients and its effects on survival were investigated.
A total of 389 patients who received adjuvant chemotherapy from 600 premenopausal patients who were treated with early stage breast cancer during 2000-2013 and followed up were included in the study. Patients who did not undergo medical ovarian ablation (OA); Amenore as developing and non-developing, two groups were separated and compared with clinicopathologic features and survival. SPSS 17. version was used.
Disease-free survival (DFS): median (m) 57 months (4-197 months), overall survival (OS): m 60 (10-168 months) and follow up time m 60 months (23-168 months). During follow-up, chemotherapy induced amenorrhea (CIA) was observed in 145 (57.5%) of 252 patients who did not have any ovarian ablation (OA. The 5-year OS rate of patients with CIA was significantly higher than the patients without CIA (p = 0.042, 95.9% vs 89.7 vs 158.88 vs 135.33 months, respectively). In the subgroup analysis, the OS in patients with CIA was significantly higher than in those without CIA in patients had HR (+) (p = 0.036, 97.5% vs 91.5 vs 162.13 vs. 136.20 months, respectively). There was no significant difference in the duration of OS between with CIA and without CIA of the patients who had not HR (+) (p = 0.736, 90.9% vs 86.8% and 126.16 and 133.76 months, respectively). The duration of OS was significantly longer in patients with CIA in the luminal A molecular subtype than in those luminal B molecular subtype, but the difference was not significant in patients without CIA (p = 0.027 vs p = 0.074 respectively).
The development of amenorrhea due to chemotherapy provides a significant survival advantage over those patients who do not develop amenorrhea due to chemotherapy. This advantage is more pronounced in hormone receptor positive, lymph node involvement and advanced disease. The development of amenorrhea due to chemotherapy in patients with HR negative does not affect survival. Amenorrhea development further prolongs survival compared to luminal B in the luminal A molecular subtype.
Clinical trial identification
Legal entity responsible for the study
Istanbul Bilim University, Florence Nightingale Group of Hospitals
All authors have declared no conflicts of interest.