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. 2017 Feb 14;8(7):11372-11379.
doi: 10.18632/oncotarget.14532.

The correlation of age with chemotherapy-induced ovarian function failure in breast cancer patients

Ingeborg J H Vriens  1 , Ashley J R De Bie  1 , Maureen J B Aarts  1 , Maaike de Boer  1 , Irene E G van Hellemond  1 , Joyce H E Roijen  1 , Ron J T van Golde  2 , Adri C Voogd  1 , Vivianne C G Tjan-Heijnen  1
Affiliations

The correlation of age with chemotherapy-induced ovarian function failure in breast cancer patients

Ingeborg J H Vriens et al. Oncotarget. .

Abstract

Purpose: To assess the incidence of chemotherapy-induced ovarian function failure (COFF) based on estradiol and follicle stimulating hormone (FSH) monitoring in premenopausal women with hormone-receptor positive breast cancer treated with second and third generation (neo-)adjuvant chemotherapy.

Results: We identified 115 eligible women. Two years after start of chemotherapy, COFF was significantly more often present in women ≥ 40 years (85.6%) as compared to women < 40 years (8.7%). Only age was significantly associated with COFF two years after start of chemotherapy (HR 12.26; 95% CI 5.21-28.86). In 50% of the patients, premenopausal hormone levels were the first or only evidence of ovarian function recovery (OFR).

Materials and methods: We included all premenopausal women with hormone-receptor positive breast cancer treated with anthracycline-based chemotherapy, with or without taxanes, in our university hospital in the Netherlands in the years 2005-2013. Patients were 3-monthly monitored for ovarian function. Cox proportional hazards model was used to determine the predictive impact of various parameters on the occurrence of COFF.

Conclusions: After second- or third generation (neo-)adjuvant chemotherapy, COFF was still present in 8.7% of patients < 40 years after two years. FSH and estradiol monitoring may be relevant for those in whom ovarian function suppression is considered an additional effective endocrine treatment.

Keywords: breast cancer; chemotherapy; chemotherapy induced ovarian function failure; ovarian insufficiency; premenopausal patients.

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Conflict of interest statement

CONFLICTS OF INTEREST

None declared.

Figures

Figure 1
Figure 1. Time untill OFR after COFF in premenopausal patients who had recieved (neo)adjuvant chemotherapy
COFF = Chemotherapy-induced ovarian function failure. OFR = Ovarian function recovery. Patients < 40 years of age: COFF in 92% of whom 8.7% COFF 2 years after chemotherapy. Patients ≥ 40 years of age: COFF in 100%, of whom 85.6% COFF 2 years after chemotherapy.
Figure 2
Figure 2. FSH and estradiol levels in patients with OFR after COFF two years after chemotherapy, treated with tamoxifen or aromatase inhibitors
COFF = Chemotherapy-induced ovarian function failure. OFR = Ovarian function recovery. FSH = Follicle stimulating hormone. Panel A shows that the initially highly increased FSH levels rapidly declined during treatment with tamoxifen, whereas Panel B shows that in patients receiving aromatase inhibitors FSH levels continued to be high. Further, it is shown that when the ovarian function recovered after initial COFF in patients treated with tamoxifen, both FSH (Panel C) and estradiol levels (Panel D) rapidly normalized to premenopausal levels at the same time.
See this image and copyright information in PMC

References

    1. Torino F, Barnabei A, De Vecchis L, Sini V, Schittulli F, Marchetti P, Corsello SM. Chemotherapy-induced ovarian toxicity in patients affected bij endocrine-responsive early breast cancer. Critical Reviews in Oncology/Hematology. 2014;89:27–42. - PubMed
    1. Walshe JM, Denduluri N, Swain SM. Amenorrhea in premenopausal women after adjuvant chemotherapy for breast cancer. J Clin Oncol. 2006;24:5769–5779. - PubMed
    1. Tham YL, Sexton K, Weiss H, Elledge R, Friedman LC, Kramer R. The rates of chemotherapy-induced amenorrhea in patients treated with adjuvant doxorubicin and Cyclophosphamide followed by a taxane. Am J Clin Oncol. 2007;30:126–132. - PubMed
    1. Yung M, Shin HJ, Rha SY, Jeung HC, Hong S, Moon YW, Kim HS, Oh KJ, Yang WI, Roh JK, Chung HC. The clinical outcome of chemotherapy-induced amenorrhea in premenopausal young patients with breast cancer with long-term follow-up. Ann Surg Oncol. 2010;17:3259–3268. - PubMed
    1. Okanami Y, Ito Y, Watanabe C, Iijima K, Iwase T, Tokudome N, Takahashi S, Hatake K. Incidence of chemotherapy-induced amenorrhea in premenopausal patients with breast cancer following adjuvant anthracycline and taxane. Breast Cancer. 2011;18:182–188. - PubMed