Fertility and the impact of systemic therapy on hormonal status following treatment for breast cancer

Abstract

Issues of long-term toxicity from treatment for breast cancer, including the induction of premature ovarian failure, appear to be of increasing importance for breast cancer survivors. The incidence of treatment-related amenorrhea is related to patient age and to the treatment regimen. Whereas the induction of ovarian failure may be advantageous with respect to breast cancer outcome, it is not clear that there is any advantage to permanent menopause over reversible hormonal manipulations. In addition, menopause may be associated with a variety of adverse health effects. Although nonhormonal therapies are available to manage many of the consequences of menopause, avoidance of chemotherapy-related ovarian toxicity may provide the best prospects for fertility after treatment. Pregnancy after breast cancer is a realistic consideration for some breast cancer survivors and is not clearly detrimental to either the mother or her offspring.

Biomarker prediction of chemotherapy-related amenorrhea in premenopausal women with breast cancer participating in E5103

“…This novel finding has substantial clinical relevance for pre-menopausal women with cancer requiring cytotoxic chemotherapy. Because CRA can impact prognosis [14], fertility [15], and menopausal symptoms [16], in women with breast cancer, pre-chemotherapy AMH measurement may ultimately have utility in clinical decision-making. Furthermore, identifying a pre-treatment predictor of later ovarian dysfunction could be particularly important for reproductive decision-making, as the commonly recommended fertility preservation techniques for breast cancer patients (e.g., oocyte and embryo cryopreservation) are most effective before gonadotoxic therapies are given.…”

Incidence of Chemotherapy- and Chemoradiotherapy-Induced Amenorrhea in Premenopausal Women With Stage II/III Colorectal Cancer

“…The effects of chemotherapy on ovarian function have been studied most extensively in breast cancer. [7][8][9][10][11][12] However, the effect of FOLFOX and XELOX on ovarian function and specifically on the menstrual cycle is not well studied in patients with CRC.…”

“…5,6 The effects of chemotherapy on ovarian function have been studied most extensively in breast cancer. [7][8][9][10][11][12] However, in CRC, there is currently only 1 study, to our knowledge, that tested the effects of adjuvant chemotherapy on female fertility. Cercek et al reported that 16% of women younger than 50 years had persistent amenorrhea 1 year after completion of mFOLFOX6.…”

A Retrospective Study on the Onset of Menopause after Chemotherapy: Analysis of Data Extracted from the Jean Perrin Comprehensive Cancer Center Database Concerning 345 Young Breast Cancer Patients Diagnosed between 1994 and 2012

“…Nevertheless, nowadays, the incidence of BC is increasing thus affecting higher numbers of younger women. For these young women affected by chemotherapy-induced menopause (CIM), an ovarian dysfunction due to chemotherapy has been highlighted [3][4][5][6][7][8] . Chemotherapy induces the reduction of ovarian follicles.…”