Effect of adjuvant tamoxifen and CMF on endocrine function of patients with operable breast cancer

The effect of adjuvant CMF (cyclophosphamide, methotrexate and 5-fluorouracil) and tamoxifen (TM) on endocrine function was studied in 120 women with stage I-II operable breast cancer. Sixty patients were premenopausal, of whom 25 were treated with CMF for 9 months, 25 received CMF for 9 months + TM for 2 years, started concurrently, and 10 TM alone for 2 years. In all groups treatment was started within 4 weeks from mastectomy. Sixty patients were postmenopausal and they were all treated with TM alone for 2 years. Plasma levels of estrone + estradiol -17 beta (E1 + E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (Prl), and testosterone (T) were determined in all patients before surgery and again at 3-month intervals from initiation of the adjuvant therapy. In ten patients of each treatment group FSH-LH and Prl-TSH release was determined following stimulation with releasing hormones. CMF and CMF + TM therapy resulted in amenorrhea in the majority of premenopausal patients with decrease of E1 + E2 and elevation of FSH-LH plasma concentration to levels of the post-menopausal. In premenopausal women treated with TM a marked increase of E1 + E2 was observed with unaltered FSH-LH plasma concentration. A significant fall of Prl was also present in these patients. In postmenopausal women and premenopausal patients with CMF-induced amenorrhea TM produced a marked fall of FSH-LH and a decrease of Prl plasma level. In no patients was plasma T affected by any of the treatment regimens.(ABSTRACT TRUNCATED AT 250 WORDS)