Relationship between reproductive history, anthropometrics, lifestyle factors, and the likelihood of persistent chemotherapy-related amenorrhea in women with premenopausal breast cancer

Few predictors contribute to the variability seen in chemotherapy-related amenorrhea (CRA) among premenopausal women with breast cancer; later age at menarche and smoking increase the odds of CRA.

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Mary E. Abusief, M.D., Stacey A. Missmer, Sc.D., Elizabeth S. Ginsburg, M.D., Jane C. Weeks, M.D., Ann H. Partridge, M.D., M.P.H.

Volume 97, Issue 1 , Pages 154-159



To determine the association between patient characteristics at diagnosis of premenopausal breast cancer, including gravidity, parity, age at menarche, age at first birth, alcohol use, smoking history, weight, height, and body mass index (BMI), with the development of persistent chemotherapy-related amenorrhea (CRA) in follow-up.


Retrospective cohort study.


Dana Farber Cancer Institute and Brigham and Women’s Hospital.


Premenopausal women with breast cancer.


We identified all premenopausal women who received standard adjuvant chemotherapy during 1997–2005 for whom menstrual data were available. Multivariable logistic regression models evaluating persistent amenorrhea at ≥6 month after completion of chemotherapy were conducted.

Main Outcome Measure(s):

Persistent chemotherapy-related amenorrhea (CRA) at ≥6 months from completion of chemotherapy.


A total of 431 women met eligibility criteria and had ≥6-months’ follow-up. Women with older (>13 years) vs. younger (12–13 years) age at menarche were more than twice as likely to remain amenorrheic. Current smokers had 2.4 greater odds of CRA vs. never smokers, although this association was not statistically significant (95% confidence interval, 0.86–6.75).


Few identifiable factors contribute to the variability in CRA among premenopausal women after adjuvant chemotherapy for breast cancer. Further research to improve the prediction of CRA, premature menopause, and infertility in young breast cancer survivors is warranted.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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