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Objectives: Methods:
Disruption of menstrual function and loss of reproductive potential In this retrospective experience we evaluated
in BC survivors is a frequent side effect of BC treatment. Adjuvant the incidence of CRA in 24 premenopausal BC
CT, although clearly beneficial to survival, may result in short or pts, with a median of 43 years, treated with
long-term CT-related amenorrhea (CRA), early menopause, and adjuvant CT ( A+ C, without or with
loss of reproductive potential, leading to profound physical and concomitant or sequential T). All the patients
emotional alterations. These side-effects may not only impair or had regular menstrual cycles; moreover
obstacle fertility, but also cause sexual dysfunction, bone loss and nobody received hormone therapy at the
menopausal symptoms, with a strikingly negative effect on quality same time.
of life in many women. We analyzed the incidence of CRA in
premenopausal patients (pts) affected by BC.
Patients 24 8
7
I CYCLE
6
N of patients
Results:
10 pts (42%) were treated with 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 all patients 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. CRA 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. Menstrual cycle reappeared at the
end of CT in 7 pts (32%) with a median age 40 years.
Conclusions:
In our study incidence of CRA was extremely high and there were no differences among subgroups undergoing to CT
with A + C alone or combined with T. In group of pts in which T were given concomitant with A and C, amenorrhea
occurred earlier than in the other two groups. In younger pts (7 with median age of 40 years) menstrual cycle reappeared
at the end of CT.