The role of BMI and age in chemotherapy-induced amenorrhea (CIA) in premenopausal breast cancer (PBC) patients treated with adjuvant FEC100 with or without docetaxel (D)

Background: Transitory or definitive amenorrhea (A) is a related side effect, specifically affecting young women diagnosed with breast cancer and treated with adjuvant chemotherapy (CT). Premature ovarian failure (POF) is often related to increased morbidity and mortality for heart disease and osteoporosis. In this study we analyzed the incidence of CIA in PBC patients and the correlation between their BMI and occurrence of A.Methods: 32 PBC patients, median age 44, were treated with adjuvant FEC±D. BMI was evaluated in all women. At accrual all the pts had normal menstrual activity (MA) and nobody received concomitant endocrine therapy. Results: 18 patients received FEC and 14 patients received FEC+D. In 27 patients A occurred during CT: in 89% of pts with FEC and 86% with FEC+D. In 62% of pts A occurred within first three cycles of CT. CIA occurred within the first two doses in 15/32 pts: in 44% treated with FEC and 50% with FEC+D. MA reappeared at the end of CT in 12% of pts (median age 44 years). 72% of pts had BMI<24.9 and 28% >25. In FEC group 14 pts had BMI<24.9 (61% experienced A) and 4 BMI>25 (100% experienced A); MA reappeared in 2 patients (43 and 44 ys), both with BMI<24.9. In FEC+D group 9 pts had BMI<24.9 (50% experienced A) and 5 had BMI>25 (100% experienced A); MA reappeared in 2 pts (35 and 47 years; 1 patient with BMI<24.9 and another with BMI>25). Conclusions: Our small experience showed that A occurs very frequently during FEC±D and that age is the strongest predictor for A occurrence. There was no difference in the incidence of CIA between the 2 subgroups of treatment. No correlation was observed between BMI and appearance of A.