incidence of chemotherapy-induced amenorrhea after adjuvant chemotherapy with taxane and anthracyclines in young patients with breast cancer

background: chemotherapy-induced amenorrhea is one of long term side effects of adjuvant chemotherapy in patients with breast cancer which may interfere with their future reproductive function. although amenorrhea is well recognized, the actual incidence following taxanes remains uncertain. methods: in a cross sectional study, we identified breast cancer patients aged 45 years or younger who were treated with adjuvant anthracycline and taxane-based regimens at three different oncology departments from 2001-2008. results: one hundred and nineteen patients met all eligibility criteria and consented to participate in a regular follow up program. the median age at diagnosis was 33.5 years (range, 25-41). seventy (58%) patients developed amenorrhea for at least 12 months following completion of treatment, and regular menses were maintained in another 49 (42%) patients. no statistically significant association was found between age and development of amenorrhea, although those who experienced cessation of menses were older. conclusion: although taxane containing chemotherapy was associated with higher rate of amenorrhea compared to fac, this was not statistically significant (p=0.11). also, treatment with tamoxifen and estrogen receptor (er) positive status was significantly correlated with chemotherapy induced amenorrhea. please cite this article as: pourali l, taghizadeh kermani a, ghavamnasiri mr, khoshroo f, hosseini s, asadi m, anvari k. incidence of chemotherapy-induced amenorrhea after adjuvant chemotherapy with taxane and anthracyclines in young patients with breast cancer. iran j cancer prev. 2013; 6(3):147-150. references 1. torino f , barnabei a , de vecchis l , appetecchia m , strigari l , corsello sm . recognizing menopause in women with amenorrhea induced by cytotoxic chemotherapy for endocrine-responsive early breast cancer. endocr relat cancer. 2012;19(2):21-33. 2. shapiro cl, rechet a. side effects of adjuvant treatment of breast cancer. n engl j med. 2001;344(26):1997-2008. 3. 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(2):126-32. 4. minton se, munster pn. chemotherapy-induced amenorrhea and fertility in women undergoing adjuvant treatment for breast cancer. cancer control. 2002;9(6):466-72. 5. bines j, oleske dm, cobleigh  ma. ovarian function in premenopausal women treated with adjuvant chemotherapy for breast cancer. j clin oncol. 1996; 14(5):1718-729. 6. fornier mn, modi s, panageas ks, norton l, hudis c. incidence of chemotherapy-induced, long term amenorrhea in patients with breast carcinoma age 40 year and younger after adjuvant anthracycline and taxane. cancer. 2005;104(8):1575-9. 7. di cosimo s, alimonti a, ferretti g, sperduti i, carlini p, papaldo p, et al. incidence of chemotherapy-induced amenorrhea depending on the timing of treatment by menstrual cycle phase in women with early breast cancer. ann oncol. 2004;15(7):1065-1071. 8. park h, han hs, lee h, lee ks, kang hs, lee s, et al. resumption or persistence of menstruation after cytotoxic chemotherapy is a prognostic factor for poor disease free survival in premenoposal patients with early breast cancer. ann oncol. 2012; 23(9):2283-9. 9. vanhuyse m, fournier c, bonneterre j. chemotherapy-induced amenorrhea: influence on disease-free survival and overall survival in receptor-positive premenopausal early breast cancer patients. ann oncol. 2005;16(8):1283-8. 10.  goldhirsch a, gelber rd, yothers g, gray rj, green s, bryant j, et al. adjuvant therapy for very young women with breast cancer: need for tailored treatments. j natl cancer inst monogr. 2001;(30):44-51. 11.  sukumvanich p, case ld, van zee k, singletary se, paskett ed, petrek ja, et al. incidence and time course of bleeding after long-term amenorrhea after breast cancer treatment: a prospective study. cancer. 2010 jul 1;116(13):3102-11. 12.  davis al, klitus m, mintzer dm. chemotherapy-induced amenorrhea from adjuvant breast cancer treatment: the effect of the addition of taxanes. clin breast cancer. 2005;6(5):421-4. 13.  mamounas ep, bryant j, lembersky b, fehrenbacher l, sedlacek sm, fisher b, et al. paclitaxel after doxorubicin plus cyclophosphamide as adjuvant chemotherapy for node-positive breast cancer: results from nsabp b-28. j clin oncol. 2005; 23(16):3686-96. 14. zhou wb, yin h, liu xa, zha xm, chen l, dai jc, et al. incidence of chemotherapy-induced amenorrhea associated with epirubicin, docetaxel and navelbine in younger breast cancer patients. bmc cancer. 2010;10:281. 15. walshe jm, denduluri n, swain sm. amenorrhea in premenopausal women after adjuvant chemotherapy for breast cancer. j clin oncol. 2006; 24(36):5769-79.