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Amenorrhea in women with breast cancer who received chemotherapy: a case report

  • Rajuddin Rajuddin ,
  • Derevie Hendryan Moulina ,
  • Tengku Chairannisa Putri ,


Abstract

Introduction: Breast cancer is the second most common cancer in premenopause age, has a better outcome now. Increasing early detection rates and the effectiveness of adjuvant chemotherapy treatments are factors that influence the prognosis dan survival rate. However, adjuvant chemotherapy treatment can lead to ovarian dysfunction resulting in decreased quality of life.

Case: A-29-year-old woman with breast cancer received a chemotherapy regimen of Docetaxel, Doxorubicin, and Cyclophosphamide for six cycles and had no menstrual bleeding (amenorrhoea) after chemotherapy finished. Physical examination, gynecology, and ultrasound showed no abnormalities. However, the Anti-Mullerian Hormone (AMH) immunoserology laboratory test showed shallow results.

Conclusion: The gonad toxicity effects of chemotherapy on breast cancer can cause premature ovarian failure, which can manifest as oligomenorrhea, amenorrhea, or known as chemotherapy-induced amenorrhea (CIA), which can lead to induction of premature menopause or chemotherapy-induced menopause (CIM).

Keywords: Chemotherapy-induced amenorrhea chemotherapy-induced menopause breast cancer

References

  1. Surakasula A, Nagarjunapu GC, Raghavaiah K V. A comparative study of pre- and post-menopausal breast cancer: Risk factors, presentation, characteristics and management. J Res Pharm Pract. 2014; 3(1): 12–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24991630
  2. Meng K, Tian W, Zhou M, Chen H, Deng Y. Impact of chemotherapy-induced amenorrhea in breast cancer patients: the evaluation of ovarian function by menstrual history and hormonal levels. World J Surg Oncol. 2013; 1(1): 1-7. Available from: https://doi.org/10.1186/1477-7819-11-101
  3. Rupen Shah, Kelly Rosso SDN. Pathogenesis, prevention, diagnosis and treatment of breast cancer. World J Clin Oncol. 2014; 5(3):283-98. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127601/
  4. Torino F, Barnabei A, Vecchis L De, Appetecchia M, Strigari L, Corsello SM. Recognizing menopause in women with amenorrhea induced by cytotoxic chemotherapy for endocrine-responsive early breast cancer. Endocr Relat Cancer. 2012; 19(2):21–33. Available from: https://doi.org/10.1530/ERC-11-0199
  5. Mathis KM, Sturgeon KM, Winkels RM, Wiskemann J, Williams NI, Schmitz K. Exercise and chemotherapy-induced amenorrhea. Med Hypotheses. 2018; 116 (April): 49–53. Available from: https://doi.org/10.1016/j.mehy.2018.04.022
  6. Chirgwin JH, Giobbie-hurder A, Coates AS, Price KN, Ejlertsen B, Debled M, et al. Treatment Adherence and Its Impact on Disease-Free Survival in the Breast International Group 1-98 Trial of Tamoxifen and Letrozole, Alone and in Sequence. J Clin Oncol. 2019; 34 (21):2452. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962733/
  7. Yoo C, M Ra, Ahn YJ, Hae K. Chemotherapy-induced amenorrhea, menopause-specific quality of life, and endocrine profiles in premenopausal women with breast cancer who received adjuvant anthracycline-based chemotherapy: a prospective cohort study. Cancer Chemother Pharmacol. 2013; 72(3):565-75. Available from: https://doi.org/10.1007/s00280-013-2227-5
  8. Broer SL, Eijkemans MJC, Scheffer GJ, Rooij IAJ Van, Vet A De, Themmen APN, et al. Anti-Mullerian Hormone Predicts Menopause: A Long-Term Follow-Up Study in Normoovulatory Women. J Clin Endocrinol Metab. 2011; 96(8):2532-9. Available from: https://doi.org/10.1210/jc.2010-2776
  9. Liedtke C, Kiesel L. Chemotherapy-induced amenorrhea–an update. Geburtshilfe und Frauenheilkunde. 2012;72(9):809. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651163/
  10. Gabriel CA, Domchek SM. Breast cancer in young women. Breast Cancer Res. 2010; 12(5):1-10. Available from: https://doi.org/10.1186/bcr2647
  11. Ben-Aharon I, Shalgi R. What lies behind chemotherapy-induced ovarian toxicity?. Reproduction. 2012; 144(2):153-63. Available from: https://doi.org/10.1530/REP-12-0121
  12. Satyarsa AB, Supadmanaba IG, Adiputra PA. The Role of Microrna-200c in Chemoresistant Breast Cancer. Indonesian J Health Sciences. 2020;4(2):74-83. Available from: http://dx.doi.org/10.24269/ijhs.v4i2.2423
  13. Domingo J, Guillén V, Ayllón Y, Martínez M, Muñoz E, Pellicer A, Garcia-Velasco JA. Ovarian response to controlled ovarian hyperstimulation in cancer patients is diminished even before oncological treatment. Fertil Steril. 2012; 97(4):930-4. Available from: https://www.fertstert.org/article/S0015-0282(12)00122-7/fulltext
  14. Zavos A, Valachis A. Risk of chemotherapy-induced amenorrhea in patients with breast cancer: a systematic review and meta-analysis. Acta Oncologica. 2016; 55(6):664-70. Available from: https://doi.org/10.3109/0284186X.2016.1155738
  15. Barnabei A, Strigari L, Marchetti P, Sini V, De Vecchis L, Corsello SM, et al. Predicting ovarian activity in women affected by early breast cancer: a meta-analysis-based nomogram. The oncologist. 2015; 20(10):1111-8. Available from: https://dx.doi.org/10.1634%2Ftheoncologist.2015-0183
  16. Walshe JM, Denduluri N, Swain SM. Amenorrhea in premenopausal women after adjuvant chemotherapy for breast cancer. J Clin Oncol. 2006;24(36):5769-79. Available from: http://dx.doi.org/10.1200/JCO.2006.07.2793
  17. Clowse M, Behera M, Anders C, Copland S, Coffman C, Leppert P. Ovarian Preservation by GnRH Agonists during Chemotherapy: A Meta-Analysis. J Womens Health. 2009; 18:311–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2858300/
  18. Aboulghar M. Anti-mullerian hormone in the management of infertility. Middle East Fertility Society Journal. 2014; 19(1):1-7. Available from: http://dx.doi.org/10.1016/j.mefs.2014.03.002
  19. Anderson RA, Themmen AP, -Qahtani AA, Groome NP, Cameron DA. The effects of chemotherapy and long-term gonadotrophin suppression on the ovarian reserve in premenopausal women with breast cancer. Human Reproduction. 2006; 21(10):2583-92. Available from: https://doi.org/10.1093/humrep/del201
  20. Torino F, Barnabei A, Vecchis L De, Sini V, Schittulli F, Marchetti P, et al. Chemotherapy-induced ovarian toxicity in patients affected by endocrine-responsive early breast cancer. Crit Rev Oncol/Hematol. 2014; 89(1):27–42. Available from: http://dx.doi.org/10.1016/j.critrevonc.2013.07.007
  21. Smith IE, Dowsett M, Yap Y, Walsh G, Lønning PE, Santen RJ, et al. Adjuvant Aromatase Inhibitors for Early Breast Cancer After Chemotherapy-Induced Amenorrhoea: Caution and Suggested Guidelines. J Clin Oncol. 2019; 24(16):12–5. Available from: http://dx.doi.org/10.1200/JCO.2005.05.3694
  22. Burstein HJ, Mayer E, Partridge AH, Kane HO, Litsas G, Come SE, et al. communication Invertent Use of Aromatase Inhibitors in Patients with Breast Cancer with Residual Ovarian Function: Cases and Lessons. Clin Breast Cancer. 2006; 7(2):158–61. Available from: http://dx.doi.org/10.3816/CBC.2006.n.026
  23. Codacci-pisanelli G, Del L, Del M, Peccatori FA. Mechanisms of chemotherapy-induced ovarian damage in breast cancer patients. Crit Rev Oncol / Hematol. 2017; 113:90–6. Available from: http://dx.doi.org/10.1016/j.critrevonc.2017.03.009

How to Cite

Rajuddin, R., Moulina, D. H., & Putri, T. C. (2021). Amenorrhea in women with breast cancer who received chemotherapy: a case report. Bali Medical Journal, 10(2), 534–539. https://doi.org/10.15562/bmj.v10i2.2408
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Rajuddin Rajuddin
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Derevie Hendryan Moulina
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Tengku Chairannisa Putri
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