Amenorrhea following chemotherapy for breast cancer: effect on disease-free survival

Adjuvant chemotherapy, which is known to be a cause of premature ovarian failure, is now recommended for most women diagnosed with breast cancer, and it has been postulated that the effects of chemotherapy are of the same order as those of ovarian ablation. Thus, it is important to correlate disease-free survival with induction of early menopause. We examined the literature for papers reporting the effects of chemotherapy on menstruation and ovarian changes in premenopausal women. Few studies reported such effects, but of those papers reviewed here, no such benefits in terms of disease-free survival were found. Thus, the benefits of adjuvant chemotherapy must be carefully weighed against the risk of early menopause in premenopausal women with good prognosis breast cancer.