TY - JOUR
T1 - Age of menopause among women who remain premenopausal following treatment for early breast cancer
T2 - Long-term results from International Breast Cancer Study Group Trials V and VI
AU - Partridge, Ann
AU - Gelber, Shari
AU - Gelber, Richard D.
AU - Castiglione-Gertsch, Monica
AU - Goldhirsch, Aron
AU - Winer, Eric
N1 - Funding Information:
This study was supported in part by the Program for Young Women with Breast Cancer at Dana-Farber Cancer Institute. We thank the patients, physicians, nurses and data managers who participated in the International Breast Cancer Study Group Trials V and VI. These trials and their continued follow-up were partially funded by Ludwig Institute for Cancer Research, the Cancer League of Ticino, the Swedish Cancer League, The Cancer Council Australia, Australian New Zealand Breast Cancer Trials Group, the Frontier Science and Technology Research Foundation, the Swiss Group for Clinical Cancer Research, the Swiss Cancer League, the United States National Cancer Institute (CA-75362), the Cancer Association of South Africa and the Foundation for Clinical Research of Eastern Switzerland.
PY - 2007/7
Y1 - 2007/7
N2 - Background: The likelihood of premature menopause has not been thoroughly explored in women who remain premenopausal after adjuvant chemotherapy for breast cancer. Methods: We used data from the International Breast Cancer Study Group (IBCSG) Trials V and VI. Trial V enrolled 1407 eligible premenopausal women randomised to no systemic therapy (No CT) or 1 cycle of perioperative CMF-based chemotherapy (PeCT) if node negative, and 6 cycles of CMF-based chemotherapy postoperatively (CMF × 6) or 1 cycle perioperative CMF-based chemotherapy plus CMF × 6 postoperatively (CMF × 7) if node positive. From Trial VI (a 2 × 2 factorial designed study of 3 versus 6 initial cycles of CMF and a reintroduction of three additional courses of CMF), we included 375 women randomised to receive only six initial cycles of CMF (CMF × 6). Findings: We excluded women who reported no menses during 12-24 months after randomisation (N = 934), hysterectomy (N = 16) or bilateral oophorectomy (N = 8), or missing menses data (N = 57), creating a cohort of 767 women; 540 women had been randomised to PeCT or no CT, 227 randomised to CMF × 6 or 7. A Cox proportional hazards model revealed that CMF × 6 or 7 (HR = 2.03, p < 0.0001) and temporary amenorrhea (HR = 1.96, p < 0.0001) were associated with premature menopause. Interpretation: Women who remain premenopausal after 6 or 7 cycles of CMF-based chemotherapy have a higher likelihood of going through menopause at an earlier age than women who received little or no chemotherapy. Temporary cessation of menses appears to be a marker for earlier onset of menopause. These findings may assist women and clinicians when making treatment and reproductive decisions after a diagnosis of breast cancer.
AB - Background: The likelihood of premature menopause has not been thoroughly explored in women who remain premenopausal after adjuvant chemotherapy for breast cancer. Methods: We used data from the International Breast Cancer Study Group (IBCSG) Trials V and VI. Trial V enrolled 1407 eligible premenopausal women randomised to no systemic therapy (No CT) or 1 cycle of perioperative CMF-based chemotherapy (PeCT) if node negative, and 6 cycles of CMF-based chemotherapy postoperatively (CMF × 6) or 1 cycle perioperative CMF-based chemotherapy plus CMF × 6 postoperatively (CMF × 7) if node positive. From Trial VI (a 2 × 2 factorial designed study of 3 versus 6 initial cycles of CMF and a reintroduction of three additional courses of CMF), we included 375 women randomised to receive only six initial cycles of CMF (CMF × 6). Findings: We excluded women who reported no menses during 12-24 months after randomisation (N = 934), hysterectomy (N = 16) or bilateral oophorectomy (N = 8), or missing menses data (N = 57), creating a cohort of 767 women; 540 women had been randomised to PeCT or no CT, 227 randomised to CMF × 6 or 7. A Cox proportional hazards model revealed that CMF × 6 or 7 (HR = 2.03, p < 0.0001) and temporary amenorrhea (HR = 1.96, p < 0.0001) were associated with premature menopause. Interpretation: Women who remain premenopausal after 6 or 7 cycles of CMF-based chemotherapy have a higher likelihood of going through menopause at an earlier age than women who received little or no chemotherapy. Temporary cessation of menses appears to be a marker for earlier onset of menopause. These findings may assist women and clinicians when making treatment and reproductive decisions after a diagnosis of breast cancer.
KW - Breast cancer
KW - Fertility
KW - Premature menopause
KW - Young women
UR - http://www.scopus.com/inward/record.url?scp=34447272269&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2007.04.006
DO - 10.1016/j.ejca.2007.04.006
M3 - Article
C2 - 17512721
AN - SCOPUS:34447272269
SN - 0959-8049
VL - 43
SP - 1646
EP - 1653
JO - European Journal of Cancer
JF - European Journal of Cancer
IS - 11
ER -