Li Chia-Ying, Chen Mei-Ling
MSN, RN, Doctoral Student, Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan, ROC.
PhD, RN, Professor, School of Nursing, College of Medicine, Chang Gung University, Professor (Joint Appointment), Department of Nursing, Chang Gung University of Science and Technology, and Researcher (Joint Appointment), Division of Medical Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan, ROC.
Hu Li Za Zhi. 2016 Oct;63(5):19-26. doi: 10.6224/JN.63.5.19.
Chemotherapy is a common adjuvant therapy for breast cancer that improves survival rates by killing residual cancer cells. However, this intervention may damage the germ cells within the ovary and interrupt the menstrual cycle, ultimately leading to chemotherapy-induced amenorrhea (CIA). The incidence of CIA depends on how broadly this term is defined. Around 75% of premenopausal breast cancer women treated with chemotherapy will develop CIA. Age, having a relatively long chemotherapy cycle duration, being estrogen-receptor positive, and using Tamoxifen all increase the risk of CIA. Although CIA may be associated with better prognosis outcomes, breast cancer women must subsequently deal with the various menopausal symptoms that are associated with a CIA-induced drop in estrogen level (such as cognitive function decline, physical and psychological symptoms, vasomotor symptoms, reproductive and sexual function problems, and body weight change). The present article describes the female menstrual cycle, the mechanism and risk factors of CIA, and the range of menopausal symptoms. Furthermore, we summarized methods of assessing menopausal symptoms and compared five common rating scales of menopausal symptoms. By better understanding the potential menopausal symptoms, researchers and clinicians may then select the most appropriate scale based on the situational needs in order to evaluate the severity of menopausal symptoms that are experienced by breast cancer women.
化疗是乳腺癌常见的辅助治疗方法，通过杀死残留癌细胞提高生存率。然而，这种干预可能会损害卵巢内的生殖细胞并中断月经周期，最终导致化疗引起的闭经（CIA）。CIA的发生率取决于该术语的定义范围。接受化疗的绝经前乳腺癌女性中约75%会发生CIA。年龄、化疗周期持续时间相对较长、雌激素受体阳性以及使用他莫昔芬都会增加CIA的风险。虽然CIA可能与更好的预后结果相关，但乳腺癌女性随后必须应对与CIA导致的雌激素水平下降相关的各种更年期症状（如认知功能下降、身体和心理症状、血管舒缩症状、生殖和性功能问题以及体重变化）。本文描述了女性月经周期、CIA的机制和危险因素以及更年期症状的范围。此外，我们总结了评估更年期症状的方法，并比较了五种常见的更年期症状评分量表。通过更好地了解潜在的更年期症状，研究人员和临床医生可以根据具体情况选择最合适的量表，以评估乳腺癌女性经历的更年期症状的严重程度。
