Incidence and time course of bleeding after long-term amenorrhea after breast cancer treatment: A prospective study Journal Article
| Authors: | Sukumvanich, P.; Case, L. D.; Van Zee, K.; Singletary, S. E.; Paskett, E. D.; Petrek, J. A.; Naftalis, E.; Naughton, M. J. |
| Article Title: | Incidence and time course of bleeding after long-term amenorrhea after breast cancer treatment: A prospective study |
| Abstract: | BACKGROUND: The incidence of chemotherapy-induced amenorrhea (CIA) and the time to subsequent menstrual bleeding in premenopausal breast cancer patients treated with current standard chemotherapy regimens was examined. METHODS: Four hundred sixty-six women ages 20 to 45 years at the time of diagnosis of a stage I to III breast cancer were recruited between January 1998 and July 2002. Patients completed monthly bleeding calendars from the time of study recruitment. Updated medical history data were obtained at 6-month intervals. RESULTS: Most women received doxorubicin and cyclophosphamide (AC); doxorubicin, cyclophosphamide, and paclitaxel (ACT); or cyclophosphamide, methotrexate, and 5-fluorouracil (CMF). Approximately 41% of women experienced an initial 6 months of CIA, and an additional 29% had at least 1 year of CIA. Approximately half of the women with 6 months of CIA and 29% of those with 1 year of CIA resumed bleeding within the subsequent 3 years, usually in the year after their amenorrheic episode. Resumption of bleeding differed significantly by treatment regimen after 6 months of CIA (P = .002; 68% with AC, 57% with ACT, and 23% with CMF), but not after 1 year of CIA (P = .5). Of the 23% of women who experienced an initial 2-year period of CIA, 10% resumed bleeding within the ensuing 3 years after their amenorrheic episode, but none had regular menses. CONCLUSIONS: A considerable proportion of women treated with chemotherapy will experience periods of CIA, but many will resume bleeding. Newer treatment regimens such as ACT appear to have a higher resumption of bleeding compared with CMF. This finding may have implications for choice of anti-estrogen treatment and for future potential pregnancies/fertility. © 2010 American Cancer Society. |
| Keywords: | adult; cancer chemotherapy; controlled study; surgical technique; major clinical study; histopathology; doxorubicin; fluorouracil; paclitaxel; chemotherapy; methotrexate; breast cancer; mastectomy; incidence; cyclophosphamide; partial mastectomy; tamoxifen; taxanes; chemotherapy-induced amenorrhea; vagina bleeding; amenorrhea |
| Journal Title: | Cancer |
| Volume: | 116 |
| Issue: | 13 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2010-07-01 |
| Start Page: | 3102 |
| End Page: | 3111 |
| Language: | English |
| DOI: | 10.1002/cncr.25106 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 2" - "Export Date: 20 April 2011" - "CODEN: CANCA" - "Source: Scopus" |
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