绝经前乳腺癌术后辅助治疗对月经的影响

Impacts of adjuvant therapies on menstruation in patients with premenopausal breast cancer

目的探讨乳腺癌术后辅助治疗对月经的影响。方法回顾性分析2014年9月至2015年2月在我院乳腺外科门诊随诊的216例绝经前乳腺癌患者资料。探讨不同的术后辅助治疗(仅接受化疗、仅接受他莫昔芬治疗、化疗联合他莫昔芬治疗)对月经状态的影响,并对接受术后辅助化疗患者出现化疗诱导闭经的相关因素进行探讨。结果术后接受辅助化疗的患者中超过半数(58.3%)出现闭经;仅接受他莫昔芬治疗的患者极少(3.6%)出现闭经,但近半数(43.9%)出现月经不规律;化疗诱导闭经的发生与年龄、化疗方案及是否同时接受他莫昔芬内分泌治疗有关(P<0.05),年龄>40岁、蒽环为主的化疗方案及接受他莫昔芬治疗均增加化疗诱导闭经的发生率(P<0.05);月经能否恢复与年龄有关(P<0.05),年龄>40岁增加化疗诱导长期性闭经的发生率(P<0.05),而与化疗方案、是否接受他莫昔芬治疗无关(P>0.05);短暂性闭经患者月经恢复时间平均为(8.0±2.5)个月,超过12.9月者几乎不再恢复月经。结论术后辅助化疗可能导致闭经,年龄越大、蒽环为主化疗及同时接受他莫昔芬治疗者越容易发生;仅接受他莫昔芬内分泌治疗患者极少出现闭经。

Objective：To investigate the impacts of adjuvant therapies on menstruation in the patients with premenopausal breast cancer.Methods：The data of 216 patients with premenopausal breast cancer inDepartment of Breast Surgery in Peking Union Medical College Hospital from September 2014 to February 2015 were retrospectively analyzed.The patients were divided into three groups according to the adjuvant therapies：chemotherapy only group,tamoxifen therapy only group,and chemotherapy combined with tamoxifen endocrine therapy group.The impacts of different adjuvant therapies on menstruation were investigated and the factors related with chemotherapy-induced amenorrhea were also explored.Results：Approximately more than half（58.3%） patients with chemotherapy developed amenorrhea.Only 3.6% patients received tamoxifen treatment development amenorrhea nearly half（43.9%） of them developed irregular menstruation.Age,chemotherapy regimens and combined with tamoxifen treatment were associated with chemotherapy induced amenorrhea（CIA）（P〈0.05）.In the patients Aged more than 40 years,anthracycline-based chemotherapy and combined with tamoxifen treatment were associated with increased probability of CIA（P〈0.05）.Menstrual recovery was associated with age（P〈0.05）.Age〉40 years old was associated with increased probability of permanent CIA （P 〈 0.05）,however,neither chemotherapy regimens nor tamoxifen usage were associated with it（P〉0.05）.Menstrual recovery time of temporary amenorrhea was 8.0±2.5 months,and menstruation was almost no longer recovery if CIA time was more than 12.9 months.Conclusions：Chemotherapy for breast cancer can induce amenorrhea.The older age and anthracycline-based chemotherapy combined with tamoxifen treatment were more prone to amenorrhea.The patients received tamoxifen seldom develop amenorrhea.