TY - JOUR
T1 - Chemotherapy-induced ovarian toxicity in patients affected by endocrine-responsive early breast cancer
AU - Torino, Francesco
AU - Barnabei, Agnese
AU - De Vecchis, Liana
AU - Sini, Valentina
AU - Schittulli, Francesco
AU - Marchetti, Paolo
AU - Corsello, Salvatore Maria
PY - 2014
Y1 - 2014
N2 - 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-müllerian 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.
AB - 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-müllerian 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.
KW - Aromatase inhibitors
KW - Breast cancer
KW - Chemotherapy-induced amenorrhea
KW - Chemotherapy-induced menopause
KW - Ovarian reserve
KW - Aromatase inhibitors
KW - Breast cancer
KW - Chemotherapy-induced amenorrhea
KW - Chemotherapy-induced menopause
KW - Ovarian reserve
UR - http://hdl.handle.net/10807/52887
U2 - 10.1016/j.critrevonc.2013.07.007
DO - 10.1016/j.critrevonc.2013.07.007
M3 - Article
SN - 1879-0461
VL - 89
SP - 27
EP - 42
JO - CRITICAL REVIEWS IN ONCOLOGY/HEMATOLOGY
JF - CRITICAL REVIEWS IN ONCOLOGY/HEMATOLOGY
ER -