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AMENORREA FIGO

Data · December 2014

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14 authors, including:

Enrico Basso Luigi Rossi


Sapienza University of Rome Sapienza University of Rome
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Federica Tomao Anselmo Papa


Sapienza University of Rome Sapienza University of Rome
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INCIDENCE OF AMENORRHEA IN PREMENOPAUSAL
WOMEN WITH BREAST CANCER (BC) UNDERGOING
CHEMOTHERAPY (CT) WITH ANTHRACYCLINE (A),
CYCLOPHOSPHAMIDE (C) AND DOCETAXEL (T)
Enrico Basso1, Luigi Rossi1, Federica Tomao2, Anselmo Papa1, Eleonora Zaccarelli1, Gian Paolo Spinelli1, Giuseppe Lo Russo1, Federica
Zoratto1, Erika Giordani1, Monica Verrico1, Martina Strudel1, Valeria Stati1, Giulia Rinaldi1, Silverio Tomao1.
1Department of Medico-Surgical Sciences and Biotechnologies, Oncology Unit, Santa Maria Goretti Hospital - University of Rome "Sapienza", Latina, Italy.
2Department of Gynecology and Obstetrics, “Sapienza” University of Rome, Rome.

Objectives: Methods:
Disruption of menstrual function and loss of reproductive potential In this retrospective experience we evaluated
in BC survivors is a frequent side effect of BC treatment. Adjuvant the incidence of CRA in 24 premenopausal BC
CT, although clearly beneficial to survival, may result in short or pts, with a median of 43 years, treated with
long-term CT-related amenorrhea (CRA), early menopause, and adjuvant CT ( A+ C, without or with
loss of reproductive potential, leading to profound physical and concomitant or sequential T). All the patients
emotional alterations. These side-effects may not only impair or had regular menstrual cycles; moreover
obstacle fertility, but also cause sexual dysfunction, bone loss and nobody received hormone therapy at the
menopausal symptoms, with a strikingly negative effect on quality same time.
of life in many women. We analyzed the incidence of CRA in
premenopausal patients (pts) affected by BC.

Patients 24 8
7
I CYCLE
6
N of patients

Median age 43 5 II CYCLE


4
III CYCLE
3
Treatment AC 10 2
FOLLOWING CYCLES
1
TAC 6 0
AC + T 8 Cycles of chemotherapy

Tab 1: Patients features. Graphic 1: Occurrence of amenorrhea during chemotherapy.

Results:
10 pts (42%) were treated with only A + C, 6 pts (25%) received A + C + T, 8 pts (33%) received A + C and after T. In 22
pts (92%) amenorrhea appeared during CT; in particular, 9/10 pts (90%) treated with A + C , 5/6 pts (83%) with A + C + T
and 8/8 pts (100%) with A + C and after T. In all patients amenorrhea appeared during first three cycles of CT in 18 pts
(82%) and particularly 7 pts (32%) after 1 cycle, 7 pts (32%) after 2 cycles, 4 pts (18%) after 3 cycles and 4 pts (18%) in
subsequent doses. CRA occurred within the first two doses of treatment in 14/22 pts (64%); in 6/9 pts (66.7%) treated
with A + C, in 4/5 pts (80%) with A + C + T and in 4/8 (50%) with A + C and after T. Menstrual cycle reappeared at the
end of CT in 7 pts (32%) with a median age 40 years.

Conclusions:
In our study incidence of CRA was extremely high and there were no differences among subgroups undergoing to CT
with A + C alone or combined with T. In group of pts in which T were given concomitant with A and C, amenorrhea
occurred earlier than in the other two groups. In younger pts (7 with median age of 40 years) menstrual cycle reappeared
at the end of CT.

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