AMENORRHEA INDUCED BY ADJUVANT CHEMOTHERAPY IN EARLY BREAST-CANCER PATIENTS - PROGNOSTIC ROLE AND CLINICAL IMPLICATIONS

Background: The role of amenorrhea induced by chemotherapy in premenop ausal women with early breast cancer is very controversial. Analyses b y various authors of the effect of drug-induced amenorrhea (DIA) on tr eatment outcome have yielded conflicting results. In order to gain ins ight into the role of DIA, we reviewed all published data addressing t he issue of DIA;as a prognostic factor. Methods: Computerised and manu al searches were conducted of relevant studies published from 1966 to 1995. Results: Thirteen studies involving 3929 patients were selected. In two papers, the prognostic role of DIA was analysed in three and t wo different groups of patients, respectively. Overall, 16 groups of p atients were evaluated. With 12 groups, a higher disease free survival was observed in patients developing DIA compared to those who did not . This difference was statistically significant in eight groups. Data on overall survival, reported in only five studies, indicated that it was always improved in patients who became amenorrheic. Conclusions: A vailable data on the role of DIA support its importance as a favorable prognostic factor for early breast cancer patients. However, due to t he possible biases of this type of evaluation, this result should be i nterpreted with caution.