الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Adjuvant chemotherapy in breast cancer prolongs the disease-free survival and overall survival, but at the same time it has an effect on ovarian function as it can induce premature ovarian failure, one of the symptoms of this premature ovarian failure is amenorrhea.
Here, in our study we tried to observe the hormonal changes in the early breast cancer patients who developed chemotherapy-induced amenorrhea, and if there is an impact of this chemotherapy-induced amenorrhea on the relapse-free survival an overall survival.
We followed the serum levels of estradiol and follicular-stimulating hormone in fifty patients who developed chemotherapy-induced amenorrhea for one year, and we found that the estradiol levels decreased once the amenorrhea developed in these patients and the follicular-stimulating hormone levels was increased, to levels similar to those with primary ovarian failure.
Then, after six months from development of chemotherapy-induced amenorrhea the estradiol levels increased and the follicular-stimulating hormone levels decreased, this may be due to the effect of tamoxifen which act as ovarian stimulant. Then after one year, the estradiol levels increased and the levels of follicular-stimulating hormone still decreased.
Also, patients with follicular-stimulating hormone levels more than or equal to forty IU/L, and/or estradiol levels less than twenty pg/ml, once amenorrhea was recorded with chemotherapy, not regained their normal menses for one year of follow-up.
Also, by following the files of 258 patients with early breast cancer in this study who developed chemotherapy-induced amenorrhea between the year 2003 to the end of the year 2007, in the Department of Cancer Management and Research in the Medical Research Institute, we found that there was a statistically significant relation between the age of the patient and the chemotherapy-induced amenorrhea occurrence.
The patients who were older than forty years had a higher rate of chemotherapy-induced amenorrhea than those who were younger than forty years, and the chemotherapy-induced amenorrhea tend to occur early in the course of treatment in the older patients.
Patients who developed chemotherapy-induced amenorrhea had a better relapse-free survival and overall survival than those who did not developed it, but this difference was not statistically significant.
In a multi-variant analysis to correlate relapse-free survival and overall survival to chemotherapy-induced amenorrhea in this study, it was found that the chemotherapy-induced amenorrhea was not an independent prognostic variable.