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the influence of endocrine effects of adjuvant therapy on quality of life outcomes in younger breast cancer survivors.doc

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the influence of endocrine effects of adjuvant therapy on quality of life outcomes in younger breast cancer survivors

The Influence of Endocrine Effects of Adjuvant Therapy on Quality of Life Outcomes in Younger Breast Cancer Survivors 【关键词】nbsp; Breast,cancer,amp;#8226;,Fertility,amp;#8226;,Gonadal,toxicity,amp;#8226;,Menopause,amp;#8226;,Quality,of,life 　　LEARNING OBJECTIVESnbsp; 　　After completing this course, the reader will be able to: 　　Identify risk factors for amenorrhea by age for young women treated with adjuvant chemotherapy. 　　Describe the associated quality of life outcomes with premature menopause as a sequelae of cancer therapy. 　　Discuss the safety and efficacy of fertility preservation options for women with breast cancer. 　　ABSTRACTnbsp; nbsp; 　　Significance. There are 2.2 million breast cancer survivors, and approximately 25%30% of newly diagnosed women each year are lt;50 years of age. Adjuvant therapy has prolonged survival, but the quality of that survival is influenced by persistent and late effects of therapy. Knowledge of treatment outcomes will assist in the design of interventions to prevent or manage persistent and late effects in survivors. 　　Purpose. The purpose of this paper is to review the incidence of gonadal toxicity associated with adjuvant chemotherapy, side effects of endocrine therapy, quality of life outcomes, fertility concerns, and options to preserve fertility in young (lt;35 years) and young midlife (3550 years) breast cancer survivors. 　　Results. Alkylating agentbased chemotherapy causes destruction of primordial follicles and impairment of follicular maturation resulting in temporary preservation of menses, reversible amenorrhea, irregular menses (perimenopause), or irreversible amenorrhea (ovarian failure―menopause). Younger women have a lower risk for amenorrhea with chemotherapy because of sufficient follicular stores, although the gonadal toxicity will result in an earlier than expected menopause. Premature menopause is associated with poorer quality of life, decreased sexual functi