The correlation of age with chemotherapy-induced ovarian function failure in breast cancer patients

Abstract

PurposeTo assess the incidence of chemotherapy-induced ovarian function failure (COFF) based on estradiol and follicle stimulating hormone (FSH) monitoring in premenopausal women with hormone-receptor positive breast cancer treated with second and third generation (neo-)adjuvant chemotherapy.ResultsWe identified 115 eligible women. Two years after start of chemotherapy, COFF was significantly more often present in women ≥ 40 years (85.6%) as compared to women < 40 years (8.7%). Only age was significantly associated with COFF two years after start of chemotherapy (HR 12.26; 95% CI 5.21–28.86). In 50% of the patients, premenopausal hormone levels were the first or only evidence of ovarian function recovery (OFR).Materials and MethodsWe included all premenopausal women with hormone-receptor positive breast cancer treated with anthracycline-based chemotherapy, with or without taxanes, in our university hospital in the Netherlands in the years 2005-2013. Patients were 3-monthly monitored for ovarian function. Cox proportional hazards model was used to determine the predictive impact of various parameters on the occurrence of COFF.ConclusionsAfter second- or third generation (neo-)adjuvant chemotherapy, COFF was still present in 8.7% of patients < 40 years after two years. FSH and estradiol monitoring may be relevant for those in whom ovarian function suppression is considered an additional effective endocrine treatment.

Preserving fertility in young women undergoing chemotherapy for early breast cancer; the Maastricht experience

“…In the earlier reported studies, there is no information on OFR rates. Our current and former studies have shown high OFR rates in women < 40 years [30]. A quarter of patients had OFR between 2 and 5 years after counseling.…”

“…Though FP in breast cancer patients is feasible and safe, the individual risk estimation of premature ovarian insufficiency should be part of the counseling procedure. Previously, we reported that with the currently used chemotherapy schedules, age is still the most important factor predicting OFR after chemotherapy [30,31]. Petrek et al showed that in women younger than 35 years of age, the long-term (more than 3 years after diagnosis) incidence of amenorrhea was similar to that of women who had not received chemotherapy (nearly 10%) [32].…”

Ovarian function, fertility and reproductive lifespan in cancer patients

“…Chemotherapy induced amenorrhoea due to acute ovarian failure is a common occurrence, however many women experience later recovery of ovarian function: this is very closely associated with age, as younger women have a greater ovarian reserve and thus are more likely to have sufficient follicle numbers after treatment [45,46]. The most significant long term consequences are POI (menopause by 40 years of age) and infertility (figure 2).…”

Early-Onset Breast Cancer: Effect of Diagnosis and Therapy on Fertility Concerns, Endocrine System, and Sexuality of Young Mothers in Germany

“…The risk of chemotherapy-induced amenorrhea (CIA) is well known in BC survivors. The destruction of the ovarian reserve can cause premature ovarian failure [4], and the risk for patients younger than the age of 40 years to experience CIA is estimated to range between 10 and 86% [5,6,7]. …”