Premenopausal breast cancer patient who developed amenorrhea after postoperative adjuvant chemotherapy despite a high serum estrogen level *
In patients with endocrine-sensitive breast cancer, the menopausal status is important for the selection of endocrine therapy. When chemotherapy is administered prior to endocrine therapy, it becomes more difficult to judge the menopausal status. We report a premenopausal breast cancer patient who developed amenorrhea after postoperative adjuvant chemotherapy despite a high serum estrogen level. The patient was a 42-year-old woman diagnosed with left breast cancer. She underwent left mastectomy and axillary lymph node dissection. The pathological findings revealed scirrhous carcinoma, which was estrogen receptor-positive, progesterone receptor-positive, and HER2- negative, with two positive lymph nodes. She received tamoxifen after combined cytotoxic chemotherapy as postoperative adjuvant therapy. She developed amenorrhea during the chemotherapy, which continued for two years and four months. Her serum estradiol (E2) level was very high (562.2 pg/ml). After further examinations, she was diagnosed with hypothalamuspituitary gland-related amenorrhea. Even if amenorrhea persists over a year after chemotherapy, the ovarian function might be preserved, as in this case. Therefore, serum levels of E2 and FSH should be periodically measured during endocrine therapy. (Accepted on August 22, 2013)
