Prognostic Value of Chemotherapy-Induced Amenorrhea in Breast Cancer: a Meta-Analysis

Abstract

Background: There is still a great deal of controversy with regard to the prognostic role of chemotherapyinduced amenorrhea (CIA) in breast cancer patients. To confirm whether CIA can serve as a useful factor in predicting clinical effects of systemic adjuvant chemotherapy, we performed this meta-analysis. Materials and Methods: Relevant studies were identified using PubMed, and Embase databases. Eligible study results were pooled and summary hazard ratios (HRs) with corresponding confidence intervals (CIs) were calculated. Subgroup analyses and an assessment of publication bias were also conducted. Results: A total of 8,333 patients from 11 published studies were identified through searching the databases. The pooled HRs for disease-free survival (DFS) suggested that CIA was associated with a significant reduction in the risk of recurrence, especially in patients with hormone receptor-positive lesions (overall HR=0.65, 95%CI 0.53-0.80, I 2 = 41.3%). When the five studies reporting the HR for overall survival (OS) were pooled (n=4193), a favorable trend was found (HR=0.69, 95%CI 0.52-0.91, I 2 = 51.6%). No publication bias was observed in this study. Conclusions: This meta-analysis suggests that CIA predicts a better outcome in premenopausal hormone receptor-positive breast cancer patients.

Mobile web‐based self‐management program for breast cancer patients with chemotherapy‐induced amenorrhoea: A quasi‐experimental study

“…CIA causes irregular menstrual cycles or amenorrhoea due to chemotherapy suppressing the ovarian function and lowering estrogen levels. It presents with physical and emotional symptoms, including hot flashes, night sweats, sleep changes, fatigue, mood changes, vaginal atrophy and lowered libido (Koga et al, 2017;Zha et al, 2015). Compared to natural menopause due to ageing, CIA, as a result of acute ovarian failure, causes more severe sexual dysfunction and menopausal symptoms and negatively affects the health and quality of life (QOL) of breast cancer patients, causing osteoporosis, cardiovascular disease, genitourinary dysfunction and psychological health issues (Im et al, 2019;Koga et al, 2017;Mazor et al, 2018).…”

“…The incidence of CIA is reportedly 65%-100% in breast cancer patients receiving chemotherapy; however, this differs depending on the type of drug, cumulative dose and patient's age (Mann et al, 2012;Marino et al, 2016;Mazor et al, 2018;Zha et al, 2015).…”

“…Although CIA cannot be prevented and is a necessary consequence of breast cancer treatment, the patient's QOL can be improved depending on how well the CIA-related symptoms are managed. Given that CIA has been reported to increase the risk of depression and various chronic diseases when it is not properly managed, proactive interventions to improve QOL must be provided for breast cancer patients experiencing CIA (Zha et al, 2015). Since the symptoms and health problems caused by CIA are an important cause of poor health status and reduced QOL in survivors, it is essential to establish strategies to prevent secondary health problems and improve self-management capabilities (Koga et al, 2017;Santen et al, 2017).…”

Facilitating and Inhibiting Factors in Deciding to Start Retreatment in Survivors of Breast Cancer Recurrence

“…In Iran, the annual incidence of breast cancer and its mortality rate is reported to be 36.8% and 11.9 % (2). Around 30% of patients, even those who were diagnosed to be in the early stages of the disease, experience recurrence (3,4). The highest probability of recurrence (locally or metastatic) is 5 to 10 years after the initial get sick (5).…”