Prediction of menstrual recovery patterns in premenopausal women with breast cancer taking tamoxifen after chemotherapy: an ASTRRA Substudy
Abstract Background Chemo-endocrine therapy can lead to various side effects associated with ovarian dysfunction. Predicting menstrual recovery is necessary to discuss the treatment-related issues regarding fertility and premature menopause with patients. Methods In the ASTRRA trial, patients who re...
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BMC
2024-11-01
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| Series: | Breast Cancer Research |
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| Online Access: | https://doi.org/10.1186/s13058-024-01903-9 |
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| author | Young Joo Lee Woo Chul Noh Sungchan Gwark Hyun-Ah Kim Jai Min Ryu Seung Il Kim Eun-Gyeong Lee Seock-Ah Im Yongsik Jung Min Ho Park Kyong Hwa Park Su Hwan Kang Joon Jeong Eunhwa Park Sung Yong Kim Min Hyuk Lee Lee Su Kim Woosung Lim Seonok Kim Hee Jeong Kim |
| author_facet | Young Joo Lee Woo Chul Noh Sungchan Gwark Hyun-Ah Kim Jai Min Ryu Seung Il Kim Eun-Gyeong Lee Seock-Ah Im Yongsik Jung Min Ho Park Kyong Hwa Park Su Hwan Kang Joon Jeong Eunhwa Park Sung Yong Kim Min Hyuk Lee Lee Su Kim Woosung Lim Seonok Kim Hee Jeong Kim |
| author_sort | Young Joo Lee |
| collection | DOAJ |
| description | Abstract Background Chemo-endocrine therapy can lead to various side effects associated with ovarian dysfunction. Predicting menstrual recovery is necessary to discuss the treatment-related issues regarding fertility and premature menopause with patients. Methods In the ASTRRA trial, patients who resumed ovarian function within 2 years after chemotherapy were randomized to receive tamoxifen for 5 years or OFS with tamoxifen for 2 years. With these 1298 patients, we developed a model that predicts when menstrual recovery will occur within a 3-year period after chemotherapy using variables including age, body mass index, chemotherapy regimen and duration, and serum estradiol and follicle-stimulating hormone levels. Results The data of 957 patients were used to develop the prediction model, and those of 341 patients were used for validation. In the development group, menstruation resumed in 450 patients (47.0%) within 5 years. In multivariable analysis, younger age (< 35 vs. 45, HR 7.85, 95% CI 4.63–13.30, p < 0.0001), anthracycline-based chemotherapy without taxane (vs. with taxane, HR 1.81, 95% CI 1.37–2.38, p < 0.0001), and chemotherapy duration (≤ 90 days vs. > 90 days, HR 1.32, 95% CI 1.01–1.72, p = 0.045) correlated with menstrual recovery. Using combined age, regimen, and duration of chemotherapy, we developed a simplified scoring system to estimate recovery chances and used a concordance index of 0.679 overall and 0.744 at 3 years for validation. Conclusion This model predicted timing and probability of menstrual recovery, based on their individual age, type and duration of chemotherapy in premenopausal women diagnosed with breast cancer who received tamoxifen after chemotherapy. |
| format | Article |
| id | doaj-art-763e9739f2d444adb5fbd1224211f7ad |
| institution | Kabale University |
| issn | 1465-542X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Breast Cancer Research |
| spelling | doaj-art-763e9739f2d444adb5fbd1224211f7ad2024-11-10T12:48:10ZengBMCBreast Cancer Research1465-542X2024-11-012611910.1186/s13058-024-01903-9Prediction of menstrual recovery patterns in premenopausal women with breast cancer taking tamoxifen after chemotherapy: an ASTRRA SubstudyYoung Joo Lee0Woo Chul Noh1Sungchan Gwark2Hyun-Ah Kim3Jai Min Ryu4Seung Il Kim5Eun-Gyeong Lee6Seock-Ah Im7Yongsik Jung8Min Ho Park9Kyong Hwa Park10Su Hwan Kang11Joon Jeong12Eunhwa Park13Sung Yong Kim14Min Hyuk Lee15Lee Su Kim16Woosung Lim17Seonok Kim18Hee Jeong Kim19Division of Breast Surgery, Department of Surgery, College of Medicine, Seoul St Mary’s Hospital, The Catholic University of KoreaDepartment of Surgery, Konkuk University Medical CenterDepartment of Surgery, Ewha Womans University College of Medicine, Ewha Womans University Mokdong HospitalDepartment of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical SciencesDivision of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Breast Surgery, Department of Surgery, Yonsei Cancer Center, Yonsei University College of MedicineCenter for Breast Cancer, Research Institute and Hospital, National Cancer CenterCancer Research Institute, Seoul National University Hospital, Seoul National University College of MedicineDepartment of Surgery, School of Medicine, Ajou UniversityDepartment of Surgery, Chonnam National University Medical School & Chonnam National University Hwasun HospitalDepartment of internal medicine, Division of Medical Oncology/Hematology, Korea University Anam HospitalYeungnam University College of MedicineDivision of Breast Surgery, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of MedicineDong-A University Hospital, Dong-A University College of MedicineDepartment of Surgery, Soonchunhyang University Cheonan HospitalDepartment of Surgery, Soonchunhyang University HospitalDepartment of Surgery, Chung-Ang University Gwangmyeong HospitalDepartment of Surgery, Ewha Womans University College of Medicine, Ewha Womans University Mokdong HospitalDepartment of Clinical Epidemiology and Biostatistics, Asan Medical CenterDivision of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of MedicineAbstract Background Chemo-endocrine therapy can lead to various side effects associated with ovarian dysfunction. Predicting menstrual recovery is necessary to discuss the treatment-related issues regarding fertility and premature menopause with patients. Methods In the ASTRRA trial, patients who resumed ovarian function within 2 years after chemotherapy were randomized to receive tamoxifen for 5 years or OFS with tamoxifen for 2 years. With these 1298 patients, we developed a model that predicts when menstrual recovery will occur within a 3-year period after chemotherapy using variables including age, body mass index, chemotherapy regimen and duration, and serum estradiol and follicle-stimulating hormone levels. Results The data of 957 patients were used to develop the prediction model, and those of 341 patients were used for validation. In the development group, menstruation resumed in 450 patients (47.0%) within 5 years. In multivariable analysis, younger age (< 35 vs. 45, HR 7.85, 95% CI 4.63–13.30, p < 0.0001), anthracycline-based chemotherapy without taxane (vs. with taxane, HR 1.81, 95% CI 1.37–2.38, p < 0.0001), and chemotherapy duration (≤ 90 days vs. > 90 days, HR 1.32, 95% CI 1.01–1.72, p = 0.045) correlated with menstrual recovery. Using combined age, regimen, and duration of chemotherapy, we developed a simplified scoring system to estimate recovery chances and used a concordance index of 0.679 overall and 0.744 at 3 years for validation. Conclusion This model predicted timing and probability of menstrual recovery, based on their individual age, type and duration of chemotherapy in premenopausal women diagnosed with breast cancer who received tamoxifen after chemotherapy.https://doi.org/10.1186/s13058-024-01903-9Breast neoplasmsChemotherapyMenstruationPremenopauseTamoxifen |
| spellingShingle | Young Joo Lee Woo Chul Noh Sungchan Gwark Hyun-Ah Kim Jai Min Ryu Seung Il Kim Eun-Gyeong Lee Seock-Ah Im Yongsik Jung Min Ho Park Kyong Hwa Park Su Hwan Kang Joon Jeong Eunhwa Park Sung Yong Kim Min Hyuk Lee Lee Su Kim Woosung Lim Seonok Kim Hee Jeong Kim Prediction of menstrual recovery patterns in premenopausal women with breast cancer taking tamoxifen after chemotherapy: an ASTRRA Substudy Breast Cancer Research Breast neoplasms Chemotherapy Menstruation Premenopause Tamoxifen |
| title | Prediction of menstrual recovery patterns in premenopausal women with breast cancer taking tamoxifen after chemotherapy: an ASTRRA Substudy |
| title_full | Prediction of menstrual recovery patterns in premenopausal women with breast cancer taking tamoxifen after chemotherapy: an ASTRRA Substudy |
| title_fullStr | Prediction of menstrual recovery patterns in premenopausal women with breast cancer taking tamoxifen after chemotherapy: an ASTRRA Substudy |
| title_full_unstemmed | Prediction of menstrual recovery patterns in premenopausal women with breast cancer taking tamoxifen after chemotherapy: an ASTRRA Substudy |
| title_short | Prediction of menstrual recovery patterns in premenopausal women with breast cancer taking tamoxifen after chemotherapy: an ASTRRA Substudy |
| title_sort | prediction of menstrual recovery patterns in premenopausal women with breast cancer taking tamoxifen after chemotherapy an astrra substudy |
| topic | Breast neoplasms Chemotherapy Menstruation Premenopause Tamoxifen |
| url | https://doi.org/10.1186/s13058-024-01903-9 |
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