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Annals of Oncology Advance Access originally published online on September 12, 2005
Annals of Oncology 2006 17(2):352; doi:10.1093/annonc/mdj011
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© 2005 European Society for Medical Oncology

letter to the editor

Chemotherapy-induced amenorrhea in early breast cancer

Chemotherapy-induced amenorrhea (CIA) might exert its own hormonal therapeutic effect besides the cytotoxic activity of antineoplastic drugs. Although the prognostic value of CIA still remains controversial, several studies have shown an improvement of disease-free survival (DFS) or overall survival (OS) when CIA occurred, particularly in hormone receptor-positive subpopulations [1Go–3Go].

More recently, Martin et al. [4Go] randomly assigned 1491 women with axillary node-positive breast cancer to six cycles of treatment with either docetaxel plus doxorubicin and cyclophosphamide (TAC) or fluorouracil plus doxorubicin and cyclophosphamide (FAC) as adjuvant chemotherapy after surgery. In this trial, adjuvant chemotherapy with TAC, as compared with FAC, significantly improved the rates of disease-free and overall survival among women with operable node-positive breast cancer. Nevertheless, Martin et al. [4Go] reported that CIA occurred more frequently among women in the TAC group (61.7%) than among those in the FAC group (52.4%) (P = 0.007). Therefore, considering the results reported by Martin et al. [4Go], the question immediately arises as to whether the 9% difference in the rate of CIA in favour of TAC over FAC is likely to have an influence on DFS or OS, particularly in women with hormone receptor-positive early breast cancer.

G. Ferretti1,*, P. Carlini1, E. Bria1, A. Felici1, D. Giannarelli2, M. Ciccarese1, P. Papaldo1, A. Fabi1 and F. Cognetti1

1 Department of Medical Oncology Cancer Institute; 2 Biostatistics Unit, Regina Elena Cancer Institute, Rome, Italy

* (E-mail: gia.fer{at}flashnet.it)

References

1. Pagani O, O'Neill A, Castiglione M et al. Prognostic impact of amenorrhoea after adjuvant chemotherapy in premenopausal breast cancer patients with axillary node involvement: results of the International Breast Cancer Study Group (IBCSG) Trial VI. Eur J Cancer 1998; 34: 632–640.[CrossRef][Web of Science][Medline]

2. Poikonen P, Saarto T, Elomaa I, Joensuu H, Blomqvist C. Prognostic effect of amenorrhoea and elevated serum gonadotropin levels induced by adjuvant chemotherapy in premenopausal node-positive breast cancer patients. Eur J Cancer 2000; 36: 43–48.[Web of Science][Medline]

3. Vanhuyse M, Fournier C, Bonneterre J. Chemotherapy-induced amenorrhea: influence on disease-free survival and overall survival in receptor-positive premenopausal early breast cancer patients. Ann Oncol 2005; 16: 1283–1288.[Abstract/Free Full Text]

4. Martin M, Pienkowski T, Mackey J et al. Adjuvant docetaxel for node-positive breast cancer. New Engl J Med 2005; 352: 2302–2313.[Abstract/Free Full Text]


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This Article
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