Breast cancer is the second most frequent cancer among women. Disease free survival (DFS) and overall survival (OS) have been improved by different adjuvant chemotherapy regimens; as a consequence, premenopausal patients developed chemotherapy-induced amenorrhea (CIA). Although chemotherapy and ovarian ablation independently improve the outcome of breast cancer, there is controversy about the effect of CIA in these patients. The aim of this study was to analyze the prognostic impact of chemotherapy- induced amenorrhea (CIA) on disease-free survival and overall survival in premenopausal patients with breast cancer following adjuvant chemotherapy.
Retrospectively, we reviewed the data of 200 premenopausal breast cancer patients, who underwent adjuvant chemotherapy at the Clinical Oncology Department of Ain Shams University, Cairo, Egypt during 2014. The data of one hundred ninety-two patients were analyzed in the study. CIA was defined as the absence of menstruation for a year after the end of chemotherapy. The survival analyses were done using the Kaplan-Meier method and the log Rank Test.
The median follow-up was 4 years. Mean age was 40.8 ± 6 years. CIA occurred in 66.1% of patients. Age and tumor grade were CIA predictors in logistic regression analysis. The 4-year disease-free survival (DFS) was higher in the CIA group than that in the non-CIA group (47.39 months vs 31.80 months, respectively; P = < 0.001), and the 4- year overall survival (OS) was higher in the CIA group than that of the non-CIA group (47.85 months vs 45.296 months, respectively; P = 0.030).
Chemotherapy-induced amenorrhea positively affects disease-free survival and overall survival in the Egyptian premenopausal breast cancer patients treated with adjuvant chemotherapy. It was a better prognostic marker and might be used as a surrogate marker for effective chemotherapy in those patients.
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