The correlation of age with chemotherapy-induced ovarian function failure in breast cancer patients

Purpose: To assess the incidence of chemotherapy-induced ovarian function failure (COFF) based on estradiol and follicle stimulating hormone (FSH) monitoring in premenopausal women with hormone-receptor positive breast cancer treated with second and third generation (neo-) adjuvant chemotherapy.

Results: We identified 115 eligible women. Two years after start of chemotherapy, COFF was significantly more often present in women >= 40 years (85.6%) as compared to women <40 years (8.7%). Only age was significantly associated with COFF two years after start of chemotherapy (HR 12.26; 95% CI 5.21-28.86). In 50% of the patients, premenopausal hormone levels were the first or only evidence of ovarian function recovery (OFR).

Materials and Methods: We included all premenopausal women with hormone-receptor positive breast cancer treated with anthracycline-based chemotherapy, with or without taxanes, in our university hospital in the Netherlands in the years 2005-2013. Patients were 3-monthly monitored for ovarian function. Cox proportional hazards model was used to determine the predictive impact of various parameters on the occurrence of COFF.

Conclusions: After second- or third generation (neo-) adjuvant chemotherapy, COFF was still present in 8.7% of patients <40 years after two years. FSH and estradiol monitoring may be relevant for those in whom ovarian function suppression is considered an additional effective endocrine treatment.