Assessment of parameters associated with ovarian function recovery in premenopausal women with early breast cancer and chemotherapy-induced amenorrhea in real-world clinical practice.

BACKGROUND

Chemotherapy-induced amenorrhea and premature ovarian failure are important survivorship issues for young women undergoing treatment for breast cancer. However, factors predictive of ovarian function recovery are not well established, and there is a lack of evidence supporting an appropriate surrogate marker for ovarian function recovery in clinical practice. We therefore aimed to assess, in the real-world setting, the impact of various factors on menses recovery.

PATIENTS AND

METHODS

We retrospectively analyzed 408 pre-menopausal patients with early breast cancer who received chemotherapy from our department's database, 308 of whom were evaluable for menses recovery. The primary endpoint was the assessment of menses recovery. The factors evaluated were age at diagnosis, hormonal receptor status and adjuvant hormonal treatment, HER2 status, prophylactic use of GnRH analogs, anthracycline use, and a hormonal profile of FSH, LH, and E2. The impact of menses recovery on disease-free survival was also assessed.

RESULTS

Age was found to have a statistically significant impact on menstrual recovery (p < 0.0001), as did the prophylactic use of GnRH analogs (p < 0.0001). Patients that received adjuvant hormonal treatment had a statistically significant longer time to menstrual recovery than patients who did not (p < 0.0001), a difference which was more prominent in younger patients. Anthracycline use and HER2-positivity did not have an impact on ovarian function recovery. A hormonal profile of FSH, LH and β2-estradiol collected in the beginning of patient's follow-up was statistically significant for predicting menstrual recovery. The absence of menstrual recovery was statistically significant for improved disease-free survival (HR: 0.37, p = 0.0566).

CONCLUSION

Our study demonstrated parameters that can be used in clinical practice to guide patients counseling about ovarian function recovery in premenopausal women with early breast cancer.