Age of menopause among women who remain premenopausal following treatment for early breast cancer: Long-term results from International Breast Cancer Study Group Trials V and VI

Ann Partridge, Shari Gelber, Richard D. Gelber, Monica Castiglione-Gertsch, Aron Goldhirsch, Eric Winer

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)1646-1653
Number of pages8
JournalEuropean Journal of Cancer
Volume43
Issue number11
DOIs
Publication statusPublished - Jul 2007

Keywords

  • Breast cancer
  • Fertility
  • Premature menopause
  • Young women

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

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