Koga Chinami, Akiyoshi Sayuri, Ishida Mayumi, Nakamura Yoshiaki, Ohno Shinji, Tokunaga Eriko
Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.
Cancer Institute Hospital, Breast Cancer Center, 3-8-31 Ariake, Koutou-ku, 135-8550, Tokyo, Japan.
Breast Cancer. 2017 Sep;24(5):714-719. doi: 10.1007/s12282-017-0764-1. Epub 2017 Feb 27.
For premenopausal women with breast cancer, information on the effects of chemotherapy and the risk of infertility is important. In this study, the effect of chemotherapy on the ovarian function in premenopausal women with hormone receptor-positive breast cancer was investigated, with an age-stratified analysis of the appearance of amenorrhea and the resumption of menstruation after the use of chemotherapy with anthracyclines or taxanes.
Premenopausal women diagnosed with operable Stage I-III hormone receptor-positive breast cancer and underwent neoadjuvant or adjuvant chemotherapy with the standard regimen of anthracyclines and/or taxanes were included. The patients were classified into age groups in 5-year increments, and the rates of chemotherapy-induced amenorrhea (CIA), resumption of menstruation, and duration of CIA after chemotherapy were analyzed.
The subjects consisted of 101 patients (median age 45 years). CIA occurred in 97 (96%) patients and 40 patients resumed menstruation. In all patients aged ≤39 years menstruation restarted, whereas in all patients aged ≥50 years, menstruation did not restart. For the patients who resumed menstruation, the younger the patients, the sooner menstruation tended to restart. The resumption of menstruation occurred within 1 year for younger patients aged around 30 years, but for those aged ≥35 years, 60% of cases took around 2-3 years for resumption.
The incidence of CIA, the resumption of menstruation and duration of CIA after chemotherapy depend greatly on the patient's age.
对于绝经前乳腺癌患者,化疗效果及不孕风险的信息至关重要。本研究调查了化疗对激素受体阳性绝经前乳腺癌患者卵巢功能的影响,并对使用蒽环类或紫杉类化疗后闭经出现及月经恢复情况进行了年龄分层分析。
纳入诊断为可手术的Ⅰ-Ⅲ期激素受体阳性乳腺癌且接受蒽环类和/或紫杉类标准方案新辅助或辅助化疗的绝经前女性。患者按年龄以5岁为增量分组,分析化疗诱导闭经(CIA)发生率、月经恢复情况及化疗后CIA持续时间。
研究对象包括101例患者(中位年龄45岁)。97例(96%)患者出现CIA,40例患者月经恢复。所有年龄≤39岁的患者月经均重新来潮,而所有年龄≥50岁的患者月经均未重新来潮。对于月经恢复的患者,年龄越小,月经往往恢复得越早。年龄约30岁的年轻患者月经在1年内恢复,但年龄≥35岁的患者中,60%的病例月经恢复需要约2 - 3年。
化疗后CIA发生率、月经恢复情况及CIA持续时间在很大程度上取决于患者年龄。