Relationship between reproductive history, anthropometrics, lifestyle factors, and the likelihood of persistent chemotherapy-related amenorrhea in women with premenopausal breast cancer
Relationship between reproductive history, anthropometrics, lifestyle factors, and the likelihood of persistent chemotherapy-related amenorrhea in women with premenopausal breast cancer
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DOI：
10.1016/j.fertnstert.2011.10.005
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发表时间：
2012-01-01
影响因子：
6.7
通讯作者：
Partridge, Ann H.
中科院分区：
文献类型：
--
作者：
Abusief, Mary E.;Missmer, Stacey A.;Partridge, Ann H.
目的：确定绝经前乳腺癌患者诊断时的特征（包括妊娠、产次、初潮年龄、首次生育年龄、饮酒、吸烟史、体重、身高和体重指数（BMI））与随访中持续化疗相关闭经（CRA）的关系。设计：回顾性队列研究。Dana Farber癌症研究所和Brigham妇女医院。患者：绝经前乳腺癌妇女。干预：我们确定了1997-2005年期间接受标准辅助化疗的所有绝经前妇女，她们的月经数据可用。多变量逻辑回归模型评估化疗结束后持续闭经≥ 6个月。主要结果测量：化疗结束后持续化疗相关闭经（CRA）≥ 6个月。结果：共有431名妇女符合资格标准并进行了≥ 6个月的随访。月经初潮年龄较大（>13岁）的女性与年龄较小（12-13岁）的女性相比，保持闭经的可能性是前者的两倍多。目前吸烟者与从不吸烟者相比，CRA的几率高2.4倍，尽管这种相关性在统计学上不显著（95%置信区间，0.86-6.75）。结论：绝经前妇女乳腺癌辅助化疗后，很少有可识别的因素导致CRA的变异性。进一步的研究，以提高预测CRA，过早绝经，不孕症的年轻乳腺癌幸存者是必要的。（Fertil Steril（R）2012;97：154-9. (C)美国生殖医学会（American Society for Reproductive Medicine）
Objective: To determine the association between patient characteristics at diagnosis of premenopausal breast cancer, including gravidity, parity, age at menarche, age at first birth, alcohol use, smoking history, weight, height, and body mass index (BMI), with the development of persistent chemotherapy-related amenorrhea (CRA) in follow-up.Design: Retrospective cohort study.Setting: Dana Farber Cancer Institute and Brigham and Women's Hospital.Patient(s): Premenopausal women with breast cancer.Intervention(s): We identified all premenopausal women who received standard adjuvant chemotherapy during 1997-2005 for whom menstrual data were available. Multivariable logistic regression models evaluating persistent amenorrhea at >= 6 month after completion of chemotherapy were conducted.Main Outcome Measure(s): Persistent chemotherapy-related amenorrhea (CRA) at >= 6 months from completion of chemotherapy.Result(s): A total of 431 women met eligibility criteria and had >= 6-months' follow-up. Women with older (>13 years) vs. younger (12-13 years) age at menarche were more than twice as likely to remain amenorrheic. Current smokers had 2.4 greater odds of CRA vs. never smokers, although this association was not statistically significant (95% confidence interval, 0.86-6.75).Conclusion(s): Few identifiable factors contribute to the variability in CRA among premenopausal women after adjuvant chemotherapy for breast cancer. Further research to improve the prediction of CRA, premature menopause, and infertility in young breast cancer survivors is warranted. (Fertil Steril (R) 2012;97:154-9. (C) 2012 by American Society for Reproductive Medicine.)