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Women diagnosed with breast cancer before the age of 40 and treated with chemotherapy, hormonal therapy or both may experience early menopause, according to a study in the July 20, 2011 issue of JAMA, the Journal of the American Medical Association.
However, temporarily suppressing the ovaries with hormones during chemotherapy may reduce ovarian toxicity and decrease the incidence of early menopause in young breast cancer patients, Italian researchers’ preclinical data suggests.
Approximately 6 percent of U.S. and 12 percent of global breast cancer patients are diagnosed before age 40. Among all women under 40, African Americans have a higher breast cancer incident rate, and Hispanic/Latina women have a lower rate than White women. While fewer young Hispanic/Latina women are diagnosed with breast cancer than their ethnic counterparts, they are more likely to be diagnosed with larger tumors and late stage breast cancer, according to Susan G. Komen for the Cure.
For young breast cancer patients, fertility is a concern. Chemotherapy regimens are associated with a 40 percent or more incidence of long-term amenorrhea, defined as absence of menstruation, according to background information in the article. No standard strategies for preventing chemotherapy-induced ovarian failure are yet available, but preventing adverse treatment effects may be on the horizon.
In a phase III randomized trial, researchers from the Istituto Nazionale per la Ricerca sul Cancro in Genova, Italy induced ovarian suppression in some young patients with stage I-III breast cancer with hormones secreted by the pituitary gland, known as gonadotropin-releasing hormone or GnRH analogue triptorelin, before breast cancer surgery and/or chemotherapy.
In patients receiving the hormone-induced suppression, 8.9 percent experienced early menopause compared to 25.9 percent from the chemo-only group. After treatment, 49.6 percent of the chemo-only group resumed menses while 63.3 percent did in the chemotherapy plus triptorelin group.