Levels of FSH and Estradiol in Perimenopausal and Premenopausal ER +ve and PR +ve Breast Cancer Patients with Chemotherapy Induced Ovarian Failure (CIOF) Who are Under Aromatase Inhibitors in Mansoura University Hospital

Background: Aromatase inhibitors (Als) may cause a rise in estrogen levels due to ovarian function recovery in women with clinical chemotherapy-induced ovarian failure (CIOF). We carried out a prospective registry trial to identify predictors of ovarian function recovery during AI therapy. Patients and Methods: Women with hormone receptor (HR) positive breast cancer who attend the Clinical Oncology and Nuclear Medicine Department from January 2011 to March 2013 who remained amenorrheic and had hormonal levels consistent with ovarian failure after adjuvant chemo-therapy subjects underwent frequent assessment using an ultrasensitive estradiol assay. Multivariable analysis was used to evaluate clinical and biochemical predictors of ovarian function recovery within 48 weeks. Results: Recovery of ovarian function during AI therapy was observed in 13 of 45 (28.9%) assessable subjects after a median 2.1 months (range 0.6-11.9). Median age at chemo-therapy initiation was statistically significantly different between those who regained ovarian function (43 years, range 40-51) and those who remained postmenopausal (49 years, range 45-52; p 0.0001). Conclusions: A significant proportion of women with CIOF recover ovarian function during Al therapy, including a woman over age 50 at initiation of chemotherapy. Tamoxifen remains the standard of care for women with CIOF. If an AI is used, patients should be monitored frequently with high-quality estradiol assays.