Incidencia de la quimioterapia (CT) inducida por la amenorrea en pacientes premenopáusicas (pts) con cáncer de mama (CM) siguiendo antraciclina adyuvante (A), ciclofosfamida (C), y taxano (T)

BACKGROUND:

CT may induce amenorrhea or menopause to a variable extent. These side-effects may impair or impede fertility, cause sexual dysfunction, bone loss and menopausal symptoms in many women. We analyzed incidence of amenorrhea in premenopausal pts affected by BC treated with CT.

METHODS:

In this retrospective study we evaluated the incidence of amenorrhea in 24 premenopausal BC pts (43 median age years) treated with adjuvant A + C +/- T based CT. Overall population (OP) had regular menstrual cycle and no pts began hormone therapy, at the same time.

RESULTS:

10 pts (42%) received only A + C, 6 pts (25%) received A + C + T, 8 pts (33%) received A + C and after T. In 22 pts (92%) amenorrhea appeared during CT; in particular, 9/10 pts (90%) treated with A + C , 5/6 pts (83%) with A + C + T and 8/8 pts (100%) with A + C and after T. In OP amenorrhea appeared during first three cycles of CT in 18 pts (82%) and particularly 7 pts (32%) after 1 cycle, 7 pts (32%) after 2 cycles, 4 pts (18%) after 3 cycles and 4 pts (18%) in subsequent doses. Amenorrhea occurred within the first two doses of treatment in 14/22 pts (64%); in 6/9 pts (66.7%) treated with A + C, in 4/5 pts (80%) with A + C + T and in 4/8 (50%) with A + C and after T. In 7 pts (32%), median age 40 years, at the end of CT reappeared menstrual cycle.

CONCLUSIONS:

In our small experience the incidence of amenorrhea during CT was extremely high and there are no differences between subgroups undergoing to CT with A + C alone or combined with T. In the group of pts in which T were given concomitant with A and C, amenorrhea occurred earlier than the other two groups. Menstrual cycle reappeared at the end of CT in younger pts.