Chemotherapy-induced ovarian toxicity in patients affected by endocrine-responsive early breast cancer

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• 作者：Francesco Torino ; Agnese Barnabei ; Liana De Vecchis ; Valentina Sini ; Francesco Schittulli ; Paolo Marchetti ; Salvatore Maria Corsello
• 关键词：Breast cancer ; Chemotherapy-induced amenorrhea ; Chemotherapy-induced menopause ; Aromatase inhibitors ; Ovarian reserve
• 刊名：Critical Reviews in Oncology/Hematology
• 出版年：January, 2014
• 年：2014
• 卷：89
• 期：1
• 页码：27-42
• 全文大小：1702 K

文摘

Cytotoxic chemotherapy may variably affect ovarian function depending on age and ovarian reserve at diagnosis, type of chemotherapy and use of tamoxifen.

Ascertaining whether a premenopausal patient with endocrine-responsive early breast cancer and chemotherapy-induced amenorrhea has reached menopause is essential not only in order to provide accurate information on residual fertility, but also to appropriately prescribe endocrine therapy. Indeed, aromatase inhibitors are contraindicated in women with residual ovarian reserve. However, the diagnosis of menopause in patients with chemotherapy-induced amenorrhea is challenging, since clinical features, follicle-stimulating hormone and estradiol levels may be inaccurate to this aim. Recent studies demonstrated that the anti-m眉llerian hormone may improve the assessment of ovarian reserve residual to chemotherapy in women with early breast cancer.

Herein, we review the incidence of amenorrhea and menopause induced by cytotoxic chemotherapy in women affected by early breast cancer and the suggested mechanisms that sustain these side-effects. Furthermore, it has been scrutinized the potential of new markers of ovarian reserve that may facilitate the selection of appropriate endocrine treatment for premenopausal women who develop amenorrhea following adjuvant chemotherapy for early breast cancer.