Treatment-related amenorrhea in a modern, prospective cohort study of young women with breast cancer

Abstract Young women with breast cancer experience unique treatment and survivorship issues centering on treatment-related amenorrhea (TRA), including fertility preservation and management of ovarian function as endocrine therapy. The Young Women’s Breast Cancer Study (YWS) is a multi-center, prospe...

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Autores principales:	Philip D. Poorvu, Jiani Hu, Yue Zheng, Shari I. Gelber, Kathryn J. Ruddy, Rulla M. Tamimi, Jeffrey M. Peppercorn, Lidia Schapira, Virginia F. Borges, Steven E. Come, Ellen Warner, Matteo Lambertini, Shoshana M. Rosenberg, Ann H. Partridge
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/592ffffed0fa43e097016755a05439e6
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spelling	oai:doaj.org-article:592ffffed0fa43e097016755a05439e62021-12-02T16:30:15ZTreatment-related amenorrhea in a modern, prospective cohort study of young women with breast cancer10.1038/s41523-021-00307-82374-4677https://doaj.org/article/592ffffed0fa43e097016755a05439e62021-07-01T00:00:00Zhttps://doi.org/10.1038/s41523-021-00307-8https://doaj.org/toc/2374-4677Abstract Young women with breast cancer experience unique treatment and survivorship issues centering on treatment-related amenorrhea (TRA), including fertility preservation and management of ovarian function as endocrine therapy. The Young Women’s Breast Cancer Study (YWS) is a multi-center, prospective cohort study of women diagnosed at age ≤40, enrolled from 2006 to 2016. Menstrual outcomes were self-reported on serial surveys. We evaluated factors associated with TRA using logistic regression. One year post-diagnosis, 286/789 (36.2%) experienced TRA, yet most resumed menses (2-year TRA: 120/699; 17.2%). Features associated with 1-year TRA included older age (OR ≤30vs36-40 = 0.29 (0.17–0.48), OR31-35vs36-40 = 0.67 (0.46–0.94), p = 0.02); normal body mass index (BMI) (OR ≥25vs18.5-24. =0.59 (0.41–0.83), p < 0.01); chemotherapy (ORchemo vs no chemo = 5.55 (3.60–8.82), p < 0.01); and tamoxifen (OR = 1.55 (1.11–2.16), p = 0.01). TRA rates were similar across most standard regimens (docetaxel/carboplatin/trastuzumab +/− pertuzumab: 55.6%; docetaxel/cyclophosphamide +/− trastuzumab/pertuzumab: 41.8%; doxorubicin/cyclophosphamide/paclitaxel +/− trastuzumab/pertuzumab: 44.1%; but numerically lower with AC alone (25%) or paclitaxel/trastuzumab (11.1%). Among young women with breast cancer, lower BMI appears to be an independent predictor of TRA. This finding has important implications for interpretation of prior studies, future research, and patient care in our increasingly obese population. Additionally, these data describe TRA associated with use of docetaxel/cyclophosphamide, which is increasingly being used in lieu of anthracycline-containing regimens. Collectively, these data can be used to inform use of fertility preservation strategies for women who need to undergo treatment as well as the potential need for ovarian suppression following modern chemotherapy for young women with estrogen-receptor-positive breast cancer. Clinical trial registration: www.clinicaltrials.gov, NCT01468246.Philip D. PoorvuJiani HuYue ZhengShari I. GelberKathryn J. RuddyRulla M. TamimiJeffrey M. PeppercornLidia SchapiraVirginia F. BorgesSteven E. ComeEllen WarnerMatteo LambertiniShoshana M. RosenbergAnn H. PartridgeNature PortfolioarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENnpj Breast Cancer, Vol 7, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Philip D. Poorvu Jiani Hu Yue Zheng Shari I. Gelber Kathryn J. Ruddy Rulla M. Tamimi Jeffrey M. Peppercorn Lidia Schapira Virginia F. Borges Steven E. Come Ellen Warner Matteo Lambertini Shoshana M. Rosenberg Ann H. Partridge Treatment-related amenorrhea in a modern, prospective cohort study of young women with breast cancer
description	Abstract Young women with breast cancer experience unique treatment and survivorship issues centering on treatment-related amenorrhea (TRA), including fertility preservation and management of ovarian function as endocrine therapy. The Young Women’s Breast Cancer Study (YWS) is a multi-center, prospective cohort study of women diagnosed at age ≤40, enrolled from 2006 to 2016. Menstrual outcomes were self-reported on serial surveys. We evaluated factors associated with TRA using logistic regression. One year post-diagnosis, 286/789 (36.2%) experienced TRA, yet most resumed menses (2-year TRA: 120/699; 17.2%). Features associated with 1-year TRA included older age (OR ≤30vs36-40 = 0.29 (0.17–0.48), OR31-35vs36-40 = 0.67 (0.46–0.94), p = 0.02); normal body mass index (BMI) (OR ≥25vs18.5-24. =0.59 (0.41–0.83), p < 0.01); chemotherapy (ORchemo vs no chemo = 5.55 (3.60–8.82), p < 0.01); and tamoxifen (OR = 1.55 (1.11–2.16), p = 0.01). TRA rates were similar across most standard regimens (docetaxel/carboplatin/trastuzumab +/− pertuzumab: 55.6%; docetaxel/cyclophosphamide +/− trastuzumab/pertuzumab: 41.8%; doxorubicin/cyclophosphamide/paclitaxel +/− trastuzumab/pertuzumab: 44.1%; but numerically lower with AC alone (25%) or paclitaxel/trastuzumab (11.1%). Among young women with breast cancer, lower BMI appears to be an independent predictor of TRA. This finding has important implications for interpretation of prior studies, future research, and patient care in our increasingly obese population. Additionally, these data describe TRA associated with use of docetaxel/cyclophosphamide, which is increasingly being used in lieu of anthracycline-containing regimens. Collectively, these data can be used to inform use of fertility preservation strategies for women who need to undergo treatment as well as the potential need for ovarian suppression following modern chemotherapy for young women with estrogen-receptor-positive breast cancer. Clinical trial registration: www.clinicaltrials.gov, NCT01468246.
format	article
author	Philip D. Poorvu Jiani Hu Yue Zheng Shari I. Gelber Kathryn J. Ruddy Rulla M. Tamimi Jeffrey M. Peppercorn Lidia Schapira Virginia F. Borges Steven E. Come Ellen Warner Matteo Lambertini Shoshana M. Rosenberg Ann H. Partridge
author_facet	Philip D. Poorvu Jiani Hu Yue Zheng Shari I. Gelber Kathryn J. Ruddy Rulla M. Tamimi Jeffrey M. Peppercorn Lidia Schapira Virginia F. Borges Steven E. Come Ellen Warner Matteo Lambertini Shoshana M. Rosenberg Ann H. Partridge
author_sort	Philip D. Poorvu
title	Treatment-related amenorrhea in a modern, prospective cohort study of young women with breast cancer
title_short	Treatment-related amenorrhea in a modern, prospective cohort study of young women with breast cancer
title_full	Treatment-related amenorrhea in a modern, prospective cohort study of young women with breast cancer
title_fullStr	Treatment-related amenorrhea in a modern, prospective cohort study of young women with breast cancer
title_full_unstemmed	Treatment-related amenorrhea in a modern, prospective cohort study of young women with breast cancer
title_sort	treatment-related amenorrhea in a modern, prospective cohort study of young women with breast cancer
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/592ffffed0fa43e097016755a05439e6
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Treatment-related amenorrhea in a modern, prospective cohort study of young women with breast cancer

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