Rate and Time of Ovarian Function Restoration in Menopausal Breast Cancer Patients Who Received Letrozole Following Chemotherapy

Background: the present study aimed to investigate the rate and time of ovarianfunction restoration in breast cancer patients between 40 and 60 years of age who werein menopause (biochemically documented) and received letrozole after chemotherapy.we intended to further clarify the management strategy for breast cancer patientswith different menopausal status.methods: we prospectively measured the effects of replacing tamoxifen withletrozole on ovarian function recovery in 90 women from two age groups (40-50 and51-60 years). all had breast cancer and were treated by chemotherapy. patients hadlaboratory documentation of menopause (fsh > 40 miu/ml and estradiol < 20 pg/ml).patients did not have menstruation for at least one year. study patients receivedletrozole. at three month intervals, we checked their fsh and estradiol levels.results:at three months after beginning letrozole, 12 patients in the younger agegroup had laboratory ovarian function restoration, among which three had vaginalbleeding. in the older group, 8 patients had increased estradiol levels; however, therewas no evidence of vaginal bleeding in this group. at 6, 9 and 12 months, no ovarianfunction restoration was seen in the older group. however in younger patients, 4 hadlaboratory evidence of ovarian function restoration at 6 months, 2 at 9 monthsand 1 patient showed laboratory ovarian function restoration at 12 months offollow-up. totally, there was a significant difference in the occurrence of ovarianfunction restoration between the two groups (p=0.03).conclusion: a remarkable portion of women with chemotherapy-inducedamenorrhea may develop ovarian function restoration. therefore, endocrine therapyusing aromatase inhibitors in patients with chemotherapy-induced amenorrhea shouldbe followed by a regular hormonal study.