Influence Of Chemotherapy Induced Amenorrhea On Pregnancy And Prognosis Of Young Breast Cancer Patients Who Underwent Breast Conservation Therapy

Objective: To observe the prognosis of young breast cancer patients who underwent breast conservation therapy,and explore the relationship between clinicopathological characteristics,prognosis and chemotherapy induced amenorrhea.To investigate the effect of surgery and chemotherapy induced amenorrhea to pregnancy and breastfeeding in young breast cancer patients.Methods: Medical records of 464 breast cancer patients who underwent breast conservation therapy and the age ?40 years old in Tianjin Medical University Cancer Hospital were retrospectively reviewed.Of these,112 patients were excluded because of losing follow-up,352 patients were all included in this study.In addition,there were 305 patients accepted the treatment with chemotherapy.The median follow-up period was 95 months.To investigate the association between clinicopathological characteristics and chemotherapy induced amenorrhea with clinical outcomes,and predict the security problems of fertility in young breast cancer patients after treatment.clinicopathological characteristics,chemotherapy induced amenorrhea and clinical outcomes were concluded and statistical analysis was performed by SPSS 21.0.Chi-square test and Fisher's exact test were used for analysis.Binary logistic regress was also used for analysis the association between clinicopathological characteristics with chemotherapy induced amenorrhea.Kaplan-Meier analysis was used to calculate disease-free survival and overall survival.Cox regression analysis was used for multivariate analysis.A P value <0.05 was considered significant for all analyses.Results: 1.A total of 352 cases were included in this study between 2001-2014,and the number of patients treated by BCT gradually increased.These patients were mostly stage ? and ? breast cancer,and the median age was 30 years old.The 5-year OS rate was 90.9%,and DFS rate was 84.9%.2.Positive lymph node,molecular classification,CIA,radiotherapy and endocrine therapy were independent risk factors for DFS and OS in patients who underwent breast conservation therapy.Beyond that,pregnancy and breastfeeding would not affect the prognosis of patients.3.There were statistically significant on DFS and OS between CIA and no-CIA(DFS:97.7%vs.87.1%,P=0.012;OS:91.4%vs.81.3%,P=0.001).Patients who had previous breast conservation therapy means better prognosis(DFS:P=0.001;OS:P=0.107).4.Single factor analysis,the chemotherapy regimens(P < 0.001)and the Ki-67 state were correlated with chemotherapy cause amenorrhea.The chemotherapy regimens and the Ki-67 state were independent risk factors for CIA in young breast cancer patients who underwent breast conservation therapy.5.45 young patients were pregnant after treatment,in which 14 persons completed the pregnancy,and 29 abortions.What is more,12 patients initiated breastfeeding after fertility.There were no relationship between CIA and pregnancy(P > 0.05).Conclusion: Premenopausal women in whom CIA developed had significantly better prognoses than women without CIA,and the resumption of menstruation after treatment will not affect the pregnancy of young patients.Addition to,pregnancy and breastfeeding after successfully treated breast cancer appears to be safe.However,we can observe better prognosis but reduced milk production from the patient who had previous breast conservation therapy and radiotherapy.