. 2006 Nov;24(36).
doi: 10.1200/JCO.2006.07.2793.

Amenorrhea in premenopausal women after adjuvant chemotherapy for breast cancer

Janice M Walshe 1 Neelima Denduluri  Sandra M Swain  
  • PMID: 17130515
  •     87 citations


Chemotherapy and ovarian ablation both independently improve survival in premenopausal women with hormone-sensitive breast cancer. Amenorrhea is a well-recognized occurrence after chemotherapy. The rate of chemotherapy-induced amenorrhea varies with patient age and chemotherapy regimens administered. However, the impact of chemotherapy-induced amenorrhea on prognosis is still being defined. Older studies in premenopausal women argue that the benefit with chemotherapy is a result of direct cytotoxicity alone. However, studies that restrict outcome analysis to hormone receptor-positive tumors suggest that chemotherapy has a dual mechanism in women with hormone-responsive tumors; indirect endocrine manipulation secondary to chemotherapy-induced ovarian suppression and direct cytotoxicity. The significant health ramifications involved with the induction of premature menopause as well as potential benefits necessitate a comprehensive evaluation of chemotherapy-induced amenorrhea. This review will discuss the incidence of amenorrhea with commonly-used adjuvant chemotherapeutic regimens, the possible benefits of chemotherapy-induced amenorrhea, and the challenges of interpreting the existing data in breast cancer trials.

Incidence of reversible amenorrhea in women with breast cancer undergoing adjuvant anthracycline-based chemotherapy with or without docetaxel.
Martine Berliere, Florence Dalenc, +7 authors, Jean-Pascal Machiels.
BMC Cancer, 2008 Feb 23; 8. PMID: 18291033    Free PMC article.
Amenorrhea in premenopausal women on the doxorubicin-and-cyclophosphamide-followed-by-docetaxel arm of NSABP B-30 trial.
Sandra M Swain, Stephanie R Land, +5 authors, Patricia A Ganz.
Breast Cancer Res Treat, 2008 Feb 28; 113(2). PMID: 18302020    Free PMC article.
A pilot study of predictive markers of chemotherapy-related amenorrhea among premenopausal women with early stage breast cancer.
Carey Anders, P Kelly Marcom, +12 authors, Kimberly Blackwell.
Cancer Invest, 2008 Mar 05; 26(3). PMID: 18317970    Free PMC article.
Cancer and fertility preservation: fertility preservation in breast cancer patients.
Theodoros Maltaris, Michael Weigel, +5 authors, Ralf Dittrich.
Breast Cancer Res, 2008 May 22; 10(2). PMID: 18492214    Free PMC article.
Effect of risedronate on hip structural geometry: a 1-year, double-blind trial in chemotherapy-induced postmenopausal women.
G J van Londen, S Perera, +3 authors, S L Greenspan.
Bone, 2008 Jun 04; 43(2). PMID: 18519174    Free PMC article.
Endocrine sequelae of cancer and cancer treatments.
Charles J Stava, Camilo Jimenez, Rena Vassilopoulou-Sellin.
J Cancer Surviv, 2008 Jul 24; 1(4). PMID: 18648961
Ovarian preservation by GnRH agonists during chemotherapy: a meta-analysis.
Megan E B Clowse, Millie A Behera, +4 authors, Lori A Bastian.
J Womens Health (Larchmt), 2009 Mar 14; 18(3). PMID: 19281314    Free PMC article.
Systematic Review.
Association of cyclophosphamide drug-metabolizing enzyme polymorphisms and chemotherapy-related ovarian failure in breast cancer survivors.
H Irene Su, Mary D Sammel, +6 authors, Angela DeMichele.
Fertil Steril, 2009 Apr 21; 94(2). PMID: 19376514    Free PMC article.
A randomized placebo-controlled study of tamoxifen after adjuvant chemotherapy in premenopausal women with early breast cancer (National Cancer Institute of Canada--Clinical Trials Group Trial, MA.12).
V H C Bramwell, K I Pritchard, +8 authors, L Shepherd.
Ann Oncol, 2009 Jul 25; 21(2). PMID: 19628570    Free PMC article.
Premature menopause or early menopause: long-term health consequences.
Lynne T Shuster, Deborah J Rhodes, +2 authors, Walter A Rocca.
Maturitas, 2009 Sep 08; 65(2). PMID: 19733988    Free PMC article.
Highly Cited. Review.
Antimullerian hormone and inhibin B are hormone measures of ovarian function in late reproductive-aged breast cancer survivors.
H Irene Su, Mary D Sammel, +6 authors, Angela DeMichele.
Cancer, 2009 Nov 18; 116(3). PMID: 19918920    Free PMC article.
Longer therapy, iatrogenic amenorrhea, and survival in early breast cancer.
Sandra M Swain, Jong-Hyeon Jeong, +14 authors, Norman Wolmark.
N Engl J Med, 2010 Jun 04; 362(22). PMID: 20519679    Free PMC article.
Recovery of menstruation after long-term chemotherapy and endocrine therapy in pre-menopausal patients with breast cancer.
Kenichi Sakurai, Katsuhisa Enomoto, Sadao Amano.
J Cancer Res Clin Oncol, 2010 Jun 10; 137(4). PMID: 20532911
Incidence of chemotherapy-induced amenorrhea associated with epirubicin, docetaxel and navelbine in younger breast cancer patients.
Wen-Bin Zhou, Hong Yin, +8 authors, Shui Wang.
BMC Cancer, 2010 Jun 15; 10. PMID: 20540745    Free PMC article.
Longitudinal assessment of bone loss from diagnostic computed tomography scans in gynecologic cancer patients treated with chemotherapy and radiation.
Susanta K Hui, Ali Khalil, +6 authors, Levi Downs.
Am J Obstet Gynecol, 2010 Aug 06; 203(4). PMID: 20684943    Free PMC article.
Endocrine Therapy - What Else?
Christian Marth.
Breast Care (Basel), 2008 Jan 01; 3(5). PMID: 20824023    Free PMC article.
Breast cancer in young women.
Courtney A Gabriel, Susan M Domchek.
Breast Cancer Res, 2010 Nov 12; 12(5). PMID: 21067532    Free PMC article.
Is Chemoendocrine Treatment without Alternative?
Richard Greil.
Breast Care (Basel), 2008 Jan 01; 3(4). PMID: 21076602    Free PMC article.
A comparison of disrupted sleep patterns in women with cancer-related fatigue and postmenopausal women without cancer.
Horng-Shiuann Wu, Jean E Davis, Josna P Padiyar, Hossein Yarandi.
Eur J Oncol Nurs, 2010 Nov 26; 15(4). PMID: 21093372    Free PMC article.
Menstruation recovery after chemotherapy and luteinizing hormone-releasing hormone agonist plus tamoxifen therapy for premenopausal patients with breast cancer.
Kenichi Sakurai, Sadanori Matsuo, +2 authors, Motomi Shiono.
Surg Today, 2010 Dec 31; 41(1). PMID: 21191690
Breast cancer and fertility preservation.
S Samuel Kim, Jennifer Klemp, Carol Fabian.
Fertil Steril, 2011 Jan 29; 95(5). PMID: 21272867    Free PMC article.
Menstrual history and quality-of-life outcomes in women with node-positive breast cancer treated with adjuvant therapy on the NSABP B-30 trial.
Patricia A Ganz, Stephanie R Land, +13 authors, Sandra M Swain.
J Clin Oncol, 2011 Feb 09; 29(9). PMID: 21300930    Free PMC article.
Fertility preservation in women--a practical guide to preservation techniques and therapeutic strategies in breast cancer, Hodgkin's lymphoma and borderline ovarian tumours by the fertility preservation network FertiPROTEKT.
Michael von Wolff, Markus Montag, +3 authors, Barbara Lawrenz.
Arch Gynecol Obstet, 2011 Mar 25; 284(2). PMID: 21431846    Free PMC article.
Prevention of ovarian damage and infertility in young female cancer patients awaiting chemotherapy--clinical approach and unsolved issues.
Katharina Hancke, Vladimir Isachenko, Evgenia Isachenko, Jürgen M Weiss.
Support Care Cancer, 2011 Sep 29; 19(12). PMID: 21947410
Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials.
Early Breast Cancer Trialists' Collaborative Group (EBCTCG), R Peto, +15 authors, K Pritchard.
Lancet, 2011 Dec 14; 379(9814). PMID: 22152853    Free PMC article.
Highly Cited.
Relationship between reproductive history, anthropometrics, lifestyle factors, and the likelihood of persistent chemotherapy-related amenorrhea in women with premenopausal breast cancer.
Mary E Abusief, Stacey A Missmer, +2 authors, Ann H Partridge.
Fertil Steril, 2011 Dec 24; 97(1). PMID: 22192139    Free PMC article.
The risk of amenorrhea is related to chemotherapy-induced leucopenia in breast cancer patients receiving epirubicin and taxane based chemotherapy.
Wenbin Zhou, Qiang Ding, +4 authors, Shui Wang.
PLoS One, 2012 May 23; 7(5). PMID: 22615953    Free PMC article.
Body composition changes in females treated for breast cancer: a review of the evidence.
Patricia M Sheean, Kent Hoskins, Melinda Stolley.
Breast Cancer Res Treat, 2012 Aug 21; 135(3). PMID: 22903689    Free PMC article.
Chemotherapy-induced ovarian failure as a prototype for acute vascular toxicity.
Irit Ben-Aharon, Israel Meizner, +6 authors, Salomon M Stemmer.
Oncologist, 2012 Sep 08; 17(11). PMID: 22956534    Free PMC article.
Impact of chemotherapy-induced amenorrhea in breast cancer patients: the evaluation of ovarian function by menstrual history and hormonal levels.
Kexin Meng, Wei Tian, +2 authors, Yongchuan Deng.
World J Surg Oncol, 2013 May 22; 11. PMID: 23688389    Free PMC article.
Chemotherapy-induced amenorrhea: a prospective study of brain activation changes and neurocognitive correlates.
Susan K Conroy, Brenna C McDonald, +2 authors, Andrew J Saykin.
Brain Imaging Behav, 2013 Jun 25; 7(4). PMID: 23793983    Free PMC article.
Hormonal therapies in young breast cancer patients: when, what and for how long?
Alexandre Christinat, Simona Di Lascio, Olivia Pagani.
J Thorac Dis, 2013 Jul 03; 5 Suppl 1. PMID: 23819026    Free PMC article.
Tamoxifen and ovarian function.
Martine Berliere, Francois P Duhoux, +6 authors, Jean-Pascal Machiels.
PLoS One, 2013 Jul 11; 8(6). PMID: 23840510    Free PMC article.
Oncofertility in Canada: the impact of cancer on fertility.
R Ronn, H E G Holzer.
Curr Oncol, 2013 Aug 02; 20(4). PMID: 23904772    Free PMC article.
Chemotherapy-induced amenorrhea in patients with breast cancer with a BRCA1 or BRCA2 mutation.
Adriana Valentini, Amy Finch, +10 authors, Steven A Narod.
J Clin Oncol, 2013 Aug 28; 31(31). PMID: 23980083    Free PMC article.
A multidimensional scale to measure the reproductive concerns of young adult female cancer survivors.
Jessica R Gorman, H Irene Su, +3 authors, Vanessa L Malcarne.
J Cancer Surviv, 2013 Dec 20; 8(2). PMID: 24352870    Free PMC article.
Adjuvant treatment of breast cancer in postmenopausal women: role of exemestane.
Iain Rj Macpherson, Colin Lindsay, Peter Canney.
Breast Cancer (Dove Med Press), 2010 Jan 01; 2. PMID: 24367167    Free PMC article.
Prechemotherapy antimullerian hormone, age, and body size predict timing of return of ovarian function in young breast cancer patients.
Hui-Chun Irene Su, Carolyn Haunschild, +4 authors, Angela DeMichele.
Cancer, 2014 Aug 02; 120(23). PMID: 25081546    Free PMC article.
Ovarian Ablation Using Goserelin Improves Survival of Premenopausal Patients with Stage II/III Hormone Receptor-Positive Breast Cancer without Chemotherapy-Induced Amenorrhea.
Juan Zhou, San-Gang Wu, +5 authors, Zhen-Yu He.
Cancer Res Treat, 2014 Sep 05; 47(1). PMID: 25187267    Free PMC article.
Incidence of chemotherapy-induced amenorrhea after adjuvant chemotherapy with taxane and anthracyclines in young patients with breast cancer.
Leila Pourali, Ali Taghizadeh Kermani, +4 authors, Kazem Anvari.
Iran J Cancer Prev, 2013 Jul 01; 6(3). PMID: 25250125    Free PMC article.
Breast cancer in young women: special considerations in multidisciplinary care.
Chantal Reyna, Marie Catherine Lee.
J Multidiscip Healthc, 2014 Oct 11; 7. PMID: 25300196    Free PMC article.
A review of breast cancer survivorship issues from survivors' perspectives.
Jihyoung Cho, So-Youn Jung, +9 authors, Min Hyuk Lee.
J Breast Cancer, 2014 Oct 17; 17(3). PMID: 25320616    Free PMC article.
Chemotherapy- and irradiation-induced bone loss in adults with solid tumors.
Michel D Wissing.
Curr Osteoporos Rep, 2015 Feb 26; 13(3). PMID: 25712619    Free PMC article.
Fertility preservation and breast cancer: a review.
María de Pedro, Borja Otero, Belén Martín.
Ecancermedicalscience, 2015 Mar 03; 9. PMID: 25729416    Free PMC article.
Efficient differentiation of steroidogenic and germ-like cells from epigenetically-related iPSCs derived from ovarian granulosa cells.
Raymond Anchan, Behzad Gerami-Naini, +11 authors, Zev Williams.
PLoS One, 2015 Mar 10; 10(3). PMID: 25751620    Free PMC article.
Prognostic impact of chemotherapy-induced amenorrhea on premenopausal breast cancer: a meta-analysis of the literature.
Qiong Zhou, Wenjin Yin, +2 authors, Jingsong Lu.
Menopause, 2015 Mar 19; 22(10). PMID: 25783467    Free PMC article.
Breast cancer under age 40: a different approach.
D Ribnikar, J M Ribeiro, +6 authors, F Cardoso.
Curr Treat Options Oncol, 2015 Mar 23; 16(4). PMID: 25796377
Orthotopic transplantation of cryopreserved mouse ovaries and gonadotrophin releasing hormone analogues in the restoration of function following chemotherapy-induced ovarian damage.
Qing Li, Peter Szatmary, +6 authors, Jiang Zhu.
PLoS One, 2015 Mar 27; 10(3). PMID: 25811681    Free PMC article.
Adjuvant endocrine therapy for early breast cancer: a systematic review of the evidence for the 2014 Cancer Care Ontario systemic therapy guideline.
O C Freedman, G G Fletcher, +4 authors, A Eisen.
Curr Oncol, 2015 Apr 08; 22(Suppl 1). PMID: 25848344    Free PMC article.
Chemotherapy-related amenorrhea after adjuvant paclitaxel-trastuzumab (APT trial).
Kathryn J Ruddy, Hao Guo, +17 authors, Sara M Tolaney.
Breast Cancer Res Treat, 2015 May 20; 151(3). PMID: 25981899    Free PMC article.
Adjuvant Metronomic CMF in a Contemporary Breast Cancer Cohort: What's Old Is New.
Eunpi Cho, Ann K Schwemm, +7 authors, Vijayakrishna K Gadi.
Clin Breast Cancer, 2015 May 31; 15(5). PMID: 26025883    Free PMC article.
Long-Term Follow-Up of Chemotherapy-Induced Ovarian Failure in Young Breast Cancer Patients: The Role of Vascular Toxicity.
Irit Ben-Aharon, Tal Granot, +7 authors, Salomon M Stemmer.
Oncologist, 2015 Jun 24; 20(9). PMID: 26099742    Free PMC article.
Fertility preservation in reproductive-age women facing gonadotoxic treatments.
J Roberts, R Ronn, N Tallon, H Holzer.
Curr Oncol, 2015 Aug 25; 22(4). PMID: 26300680    Free PMC article.
Predicting Ovarian Activity in Women Affected by Early Breast Cancer: A Meta-Analysis-Based Nomogram.
Agnese Barnabei, Lidia Strigari, +4 authors, Francesco Torino.
Oncologist, 2015 Sep 06; 20(10). PMID: 26341758    Free PMC article.
Cardiovascular Disease Mortality Among Breast Cancer Survivors.
Patrick T Bradshaw, June Stevens, +3 authors, Marilie D Gammon.
Epidemiology, 2015 Sep 29; 27(1). PMID: 26414938    Free PMC article.
Highly Cited.
Chemotherapy-Related Amenorrhea and Menopause in Young Chinese Breast Cancer Patients: Analysis on Incidence, Risk Factors and Serum Hormone Profiles.
Giok S Liem, Frankie K F Mo, +10 authors, Winnie Yeo.
PLoS One, 2015 Oct 21; 10(10). PMID: 26485568    Free PMC article.
Utility of gonadotropin-releasing hormone agonists for prevention of chemotherapy-induced ovarian damage in premenopausal women with breast cancer: a systematic review and meta-analysis.
Yan-Wei Shen, Xiao-Man Zhang, +6 authors, Jin Yang.
Onco Targets Ther, 2015 Dec 02; 8. PMID: 26622183    Free PMC article.
Chemotherapy-Induced Amenorrhea - An Update.
C Liedtke, L Kiesel.
Geburtshilfe Frauenheilkd, 2012 Sep 01; 72(9). PMID: 26640289    Free PMC article.
Chemotherapy in Premenopausal Breast Cancer Patients.
Ann H Partridge.
Breast Care (Basel), 2015 Dec 22; 10(5). PMID: 26688676    Free PMC article.
Managing breast cancer in younger women: challenges and solutions.
Foluso O Ademuyiwa, Amy Cyr, Jennifer Ivanovich, Maria A Thomas.
Breast Cancer (Dove Med Press), 2016 Jan 06; 8. PMID: 26730210    Free PMC article.
Adjuvant hormonal therapy in premenopausal women with breast cancer.
Lillian Smyth, Clifford Hudis.
Indian J Med Paediatr Oncol, 2016 Jan 27; 36(4). PMID: 26811586    Free PMC article.
Young female cancer survivors' use of fertility care after completing cancer treatment.
Jayeon Kim, Jennifer E Mersereau, +3 authors, Jessica R Gorman.
Support Care Cancer, 2016 Mar 05; 24(7). PMID: 26939923    Free PMC article.
Prognostic Effects of Adjuvant Chemotherapy-Induced Amenorrhea and Subsequent Resumption of Menstruation for Premenopausal Breast Cancer Patients.
Se Jeong Jeon, Jae Il Lee, Myung Jae Jeon, Maria Lee.
Medicine (Baltimore), 2016 Apr 09; 95(14). PMID: 27057900    Free PMC article.
SLCO1B1*5 polymorphism (rs4149056) is associated with chemotherapy-induced amenorrhea in premenopausal women with breast cancer: a prospective cohort study.
Toralf Reimer, Sarah Kempert, +3 authors, Dirk Koczan.
BMC Cancer, 2016 May 29; 16. PMID: 27234217    Free PMC article.
Significance of Ovarian Function Suppression in Endocrine Therapy for Breast Cancer in Pre-Menopausal Women.
A Scharl, A Salterberg.
Geburtshilfe Frauenheilkd, 2016 May 31; 76(5). PMID: 27239060    Free PMC article.
Prediction of ovarian function in premenopausal breast cancer patients with amenorrhoea after chemotherapy: a simple clinical score.
Xiao Shi Li, Qing Lv, Zheng Gui Du, Jie Chen.
Springerplus, 2016 Jul 28; 5(1). PMID: 27462500    Free PMC article.
Adoption consideration and concerns among young adult female cancer survivors.
Jessica R Gorman, Brian W Whitcomb, +4 authors, H Irene Su.
J Cancer Surviv, 2016 Oct 04; 11(1). PMID: 27696249    Free PMC article.
The correlation of age with chemotherapy-induced ovarian function failure in breast cancer patients.
Ingeborg J H Vriens, Ashley J R De Bie, +6 authors, Vivianne C G Tjan-Heijnen.
Oncotarget, 2017 Jan 12; 8(7). PMID: 28076330    Free PMC article.
Adjuvant Endocrine Therapy in Breast Cancer: Evolving Paradigms in Premenopausal Women.
Lorenzo Rossi, Olivia Pagani.
Curr Treat Options Oncol, 2017 Apr 26; 18(5). PMID: 28439796
Management of Potential Long-Term Toxicities in Breast Cancer Patients.
C C O'Sullivan, K J Ruddy.
Curr Breast Cancer Rep, 2017 May 16; 8(4). PMID: 28503254    Free PMC article.
Profiles of lipids, blood pressure and weight changes among premenopausal Chinese breast cancer patients after adjuvant chemotherapy.
Winnie Yeo, Frankie K F Mo, +8 authors, Giok S Liem.
BMC Womens Health, 2017 Jul 29; 17(1). PMID: 28750616    Free PMC article.
The Impact of Young Age for Prognosis by Subtype in Women with Early Breast Cancer.
Weibin Lian, Fangmeng Fu, +6 authors, Chuan Wang.
Sci Rep, 2017 Sep 16; 7(1). PMID: 28912475    Free PMC article.
Developing a post-treatment survivorship care plan to help breast cancer survivors understand their fertility.
Jessica R Gorman, Anne K Julian, +6 authors, H Irene Su.
Support Care Cancer, 2017 Sep 16; 26(2). PMID: 28913697    Free PMC article.
Fertility Preservation in Female Patients with Breast Cancer - a Current Overview.
Veronika Guenther, Ibrahim Alkatout, +3 authors, Soeren von Otte.
Geburtshilfe Frauenheilkd, 2017 Nov 03; 77(10). PMID: 29093602    Free PMC article.
Live birth outcomes after adolescent and young adult breast cancer.
Chelsea Anderson, Stephanie M Engel, Carey K Anders, Hazel B Nichols.
Int J Cancer, 2017 Dec 22; 142(10). PMID: 29266267    Free PMC article.
Examination of the ovotoxicity of 5-fluorouracil in mice.
M Lambouras, S H Liew, +3 authors, Karla J Hutt.
J Assist Reprod Genet, 2018 Mar 29; 35(6). PMID: 29589294    Free PMC article.
Cancer Treatment-Induced Bone Loss in Women With Breast Cancer and Men With Prostate Cancer.
Pamela Taxel, Erika Faircloth, Sana Idrees, Catherine Van Poznak.
J Endocr Soc, 2018 Jun 27; 2(7). PMID: 29942922    Free PMC article.
Prognostic Significance of Adjuvant Chemotherapy Induced Amenorrhea in Luminal A and B Subtypes.
Çetin Ordu, Kezban Nur Pilancı, +14 authors, Vahit Özmen.
Eur J Breast Health, 2018 Aug 21; 14(3). PMID: 30123884    Free PMC article.
Evaluation of menopausal status among breast cancer patients with chemotherapy-induced amenorrhea.
Bailin Zhang, Jinqi Wu, +13 authors, Xiang Wang.
Chin J Cancer Res, 2018 Sep 14; 30(4). PMID: 30210227    Free PMC article.
Counseling young women with early breast cancer on fertility preservation.
M E Elena Ter Welle-Butalid, I J H Ingeborg Vriens, +5 authors, V C G Vivianne Tjan-Heijnen.
J Assist Reprod Genet, 2019 Nov 25; 36(12). PMID: 31760547    Free PMC article.
Clinical and Genomic Risk to Guide the Use of Adjuvant Therapy for Breast Cancer.
Joseph A Sparano, Robert J Gray, +27 authors, George W Sledge.
N Engl J Med, 2019 Jun 04; 380(25). PMID: 31157962    Free PMC article.
Highly Cited.
Amenorrhea after lung cancer treatment.
Elizabeth J Cathcart-Rake, Kathryn J Ruddy, +8 authors, Ping Yang.
Menopause, 2018 Aug 29; 26(3). PMID: 30153217    Free PMC article.
Ovarian suppression for adjuvant treatment of hormone receptor-positive early breast cancer.
Kim Tam Bui, Melina L Willson, +2 authors, Annabel Goodwin.
Cochrane Database Syst Rev, 2020 Mar 07; 3. PMID: 32141074    Free PMC article.
Systematic Review.
Preserving fertility in young women undergoing chemotherapy for early breast cancer; the Maastricht experience.
Ingeborg J H Vriens, Elena M Ter Welle-Butalid, +16 authors, Vivianne C G Tjan-Heijnen.
Breast Cancer Res Treat, 2020 Apr 03; 181(1). PMID: 32236826    Free PMC article.
LHRH agonists for adjuvant therapy of early breast cancer in premenopausal women.
Shom Goel, Rohini Sharma, Anne Hamilton, Jane Beith.
Cochrane Database Syst Rev, 2009 Oct 13; (4). PMID: 19821328    Free PMC article.
Systematic Review.
The impact of menstruation persistence or recovery after chemotherapy on survival in young patients with hormone receptor negative breast cancer.
Mark van Barele, Bernadette A M Heemskerk-Gerritsen, +3 authors, Agnes Jager.
Breast, 2020 Jun 05; 52. PMID: 32497987    Free PMC article.
pS6K1 as an efficacy marker of GnRH agonist with premenopausal breast cancer.
Chan Sub Park, Jihye Choi, +6 authors, Hyun-Ah Kim.
Endocr Connect, 2019 Jun 30; 8(7). PMID: 31252399    Free PMC article.