J Gynecol Oncol.  2017 Mar;28(2):e10. 10.3802/jgo.2017.28.e10.

Feature of amenorrhea in postoperative tamoxifen users with breast cancer

Affiliations
  • 1Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea. jyhsyk@snu.ac.kr
  • 2Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.

Abstract


OBJECTIVE
Tamoxifen has been used to prevent the recurrence of breast cancer. However, tamoxifen-users frequently experience amenorrhea and it can be confused from that caused by other hormonal abnormalities. In amenorrheic patients without breast cancer, clinicians usually measure the sex hormone levels that are known to be associated with ovarian or menstrual function. This study aimed to investigate the feature of female sex hormones in premenopausal breast cancer patients undergoing tamoxifen treatment.
METHODS
The medical records of fifty-nine premenopausal breast cancer patients who underwent tamoxifen treatment were reviewed retrospectively. The study population consisted of amenorrheic patients (n=36) and patients with menstruation (n=23). Serum hormone levels were measured either specifically between cycle days 2 and 5 in menstruating patients or at any time in amenorrheic participants.
RESULTS
Serum levels of lutenizing hormone and estradiol were not statistically different according to the presence of menstruation. Serum follicle stimulating hormone level was significantly higher in amenorrheic patients (8.1±5.7 mIU/mL) than those in menstruating subjects (5.1±2.2 mIU/mL) (p=0.01). Serum concentration of thyroid stimulating hormone was lower in patients with amenorrhea (1.5±0.9 vs. 2.3±2.2 μIU/mL, p=0.04), although the prevalence of hypo- or hyperthyroidism was not different according to the pattern of menstruation.
CONCLUSION
Menstruation status and hormone levels can be influenced by tamoxifen use in reproductive age breast cancer patients. Physicians should be attentive to the alteration of pituitary hormone levels in addition to sex steroid hormones in this population.

Keyword

Tamoxifen; Amenorrhea; Breast Neoplasms

MeSH Terms

Adult
Amenorrhea/blood/*chemically induced
Antineoplastic Agents, Hormonal/*adverse effects
Breast Neoplasms/*drug therapy
Case-Control Studies
Chemotherapy, Adjuvant
Estradiol/blood
Female
Follicle Stimulating Hormone/blood
Humans
Luteinizing Hormone/blood
Middle Aged
Neoplasm Recurrence, Local/prevention & control
Premenopause/blood
Retrospective Studies
Tamoxifen/*adverse effects
Thyrotropin/blood
Antineoplastic Agents, Hormonal
Tamoxifen
Estradiol
Luteinizing Hormone
Follicle Stimulating Hormone
Thyrotropin
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