Young women with breast cancer experience unique treatment and survivorship issues centering on treatment-related amenorrhea (TRA), including fertility preservation and management of ovarian function as endocrine therapy. The Young Women’s Breast Cancer Study (YWS) is a multi-center, prospective cohort study of women diagnosed at age ≤40, enrolled from 2006 to 2016. Menstrual outcomes were self-reported on serial surveys. We evaluated factors associated with TRA using logistic regression. One year post-diagnosis, 286/789 (36.2%) experienced TRA, yet most resumed menses (2-year TRA: 120/699; 17.2%). Features associated with 1-year TRA included older age (OR_≤30vs36-40= 0.29 (0.17–0.48), OR_31-35vs36-40= 0.67 (0.46–0.94), p = 0.02); normal body mass index (BMI) (OR_{≥25vs18.5-24.} =0.59 (0.41–0.83), p < 0.01); chemotherapy (OR_{chemo vs no chemo} = 5.55 (3_.60–8.82), p < 0.01); and tamoxifen (OR = 1.55 (1.11–2.16), p = 0.01). TRA rates were similar across most standard regimens (docetaxel/carboplatin/trastuzumab +/− pertuzumab: 55.6%; docetaxel/cyclophosphamide +/− trastuzumab/pertuzumab: 41.8%; doxorubicin/cyclophosphamide/paclitaxel +/− trastuzumab/pertuzumab: 44.1%; but numerically lower with AC alone (25%) or paclitaxel/trastuzumab (11.1%). Among young women with breast cancer, lower BMI appears to be an independent predictor of TRA. This finding has important implications for interpretation of prior studies, future research, and patient care in our increasingly obese population. Additionally, these data describe TRA associated with use of docetaxel/cyclophosphamide, which is increasingly being used in lieu of anthracycline-containing regimens. Collectively, these data can be used to inform use of fertility preservation strategies for women who need to undergo treatment as well as the potential need for ovarian suppression following modern chemotherapy for young women with estrogen-receptor-positive breast cancer.

Clinical trial registration: www.clinicaltrials.gov, NCT01468246.

患有乳腺癌的年轻女性会经历以治疗相关闭经 (TRA) 为中心的独特治疗和生存问题，包括保留生育能力和作为内分泌治疗的卵巢功能管理。年轻女性乳腺癌研究 (YWS) 是一项多中心、前瞻性队列研究，对象为年龄≤40 岁被诊断出的女性，招募时间为 2006 年至 2016 年。月经结果是在系列调查中自我报告的。我们使用逻辑回归评估了与 TRA 相关的因素。诊断后一年，286/789 (36.2%) 经历了 TRA，但大多数恢复了月经（2 年 TRA：120/699；17.2%）。与 1 年 TRA 相关的特征包括年龄较大（OR _{≤ 30vs36-40} = 0.29 (0.17–0.48)，OR _31-35vs36-40 = 0.67 (0.46–0.94)， p = 0.02）；正常体重指数 (BMI)（OR _{≥ 25vs18.5-24。} =0.59 (0.41–0.83)， p < 0.01）；化疗（OR_{化疗 vs 未化疗}= 5.55 (3 _. 60–8.82), p < 0.01）；和他莫昔芬（OR = 1.55 (1.11–2.16)， p = 0.01）。大多数标准方案的 TRA 率相似（多西他赛/卡铂/曲妥珠单抗+/-帕妥珠单抗：55.6%；多西他赛/环磷酰胺+/-曲妥珠单抗/帕妥珠单抗：41.8%；多柔比星/环磷酰胺/紫杉醇+/-曲妥珠单抗/帕妥珠单抗：44.1%；但单独使用 AC（25%）或紫杉醇/曲妥珠单抗（11.1%）时，BMI 较低似乎是 TRA 的独立预测因素，这一发现对于解释先前的研究和未来的研究具有重要意义。以及我们日益肥胖的人群中的患者护理。 此外，这些数据描述了与多西他赛/环磷酰胺的使用相关的 TRA，多西紫杉醇/环磷酰胺越来越多地用于代替含蒽环类药物的治疗方案。总的来说，这些数据可用于指导需要接受治疗的女性使用生育力保留策略，以及患有雌激素受体阳性乳腺癌的年轻女性在现代化疗后可能需要卵巢抑制。

临床试验注册： www.clinicaltrials.gov，NCT01468246。