Whether adding GnRH analogs to Tamoxifen in breast cancer treatment aggravates menopause symptoms or not

Introduction: Approximately 10000 new cases of breast cancer are reported annually in Iran. According to this report, about 50% of Iranian patients are under age 50, which means that they are in the premenopausal state. Established chemotherapy induced-amenorrhea developed in 66% of these patients.Materials and Methods: We therefore designed a comparison study in which a cohort of healthy group of women undergoing natural menopause were recruited to allow comparison with women who had undergone menopause as a result of chemotherapy and had taken either Tamoxifen or Tamoxifen and GnRH analoges. Menopausal symptoms and quality of life were recorded by FACT-ES and FACT-G questionnaire.Results: Totally, we recruited 180 patients (79 patients in Tamoxifen group and 91 patients in Tamoxifen and GnRH analogs group) and 95 controls in this study. The mean age in patients and control group was 41 (range: 23-53) and 53 years (range: 48-59), respectively. (P-value<0.001) The severity of menopausal symptoms was different between groups (P<0.0001), meaning that the control group had significantly lower scores compared to both Tamoxifen (P<0.0001) and Tamoxifen-GnRH analogs (P<0.0001) groups. Tamoxifen group’s total FACT-ES score was also higher than the Tamoxifen-GnRH analogs group’s, however it was not statistically significant (P= 0.054). The results of comparing quality of life in all 3 groups showed that patients in the control group had significantly lower Physical, social/family, emotional and functional well-being scores compared to both Tamoxifen and Tamoxifen-GnRH analogs groups(P<0.001).Conclusion: The present study indicated no significant difference in menopausal symptoms between patients who received Tamoxifen and those who received Tamoxifen and GnRH analogs as their hormone therapy for breast cancer.