研究不同年龄乳腺癌患者发生化疗诱导闭经（CIA）和卵巢功能恢复（OFR）的情况，探讨不同年龄CIA乳腺癌患者内分泌药物的选择。

回顾性分析2012年1月至2015年12月于中山大学附属第一医院初次诊断并接受化疗、绝经前、有完整月经来潮情况和性激素检测随访数据的患者共123例。按年龄分为≤40岁组（35例）、>40~45岁组（34例）和>45岁组（54例），采用一般线性模型来分析各个年龄组的OFR率。

≤40岁组患者中26例（74.29%）出现CIA，29例（82.86%）患者在2年内OFR；>40~45岁组及>45岁组全部出现CIA（100.00%），2年内分别有17例（50.00%）及3例（5.56%）患者OFR，差异均有统计学意义（χ²=24.42、54.97，均P<0.01）。在密切监测卵巢功能的情况下，对19例≥48岁、出现CIA、激素受体阳性高危乳腺癌患者使用芳香化酶抑制剂（AI）。使用AI时患者的中位年龄为51.08岁（48.00~54.25岁），从闭经到使用AI中位时间为9个月（2~21个月），中位随访32个月（8~68个月），无一例出现OFR。

对于年龄≤45岁的CIA乳腺癌患者，由于OFR率高，内分泌药物应避免直接选用AI。对于≥51岁的CIA乳腺癌患者观察至少9个月，无OFR可开始使用AI，在使用AI时应定期监测卵巢功能。

To assess the incidence of ovarian function recovery (OFR) in women with breast cancer who were premenopausal at diagnosis and who underwent chemotherapy-induced amenorrhea (CIA) during treatment, and to explore the optimal endocrine therapy for breast cancer patients in different age groups with CIA.

The data of one hundred and twenty-three women from January 2012 to December 2015 diagnosed with breast cancer at the First Affiliated Hospital of Sun Yat-sen University was analyzed retrospectively. The patients were divided into ≤40 years (n=35), >40 years and ≤45 years (n=34) and >45 years (n=54) subgroups. A general linear model was used to assess incidences of OFR by agesubgroups.

26 patients (74.29%) developed CIA in ≤40 years group. Of these, 29 patinets (82.86%) regained ovarian function within 2 years; 100% of patients in >40 to 45 years and >45 years groups developedCIA, and 17 (50.00%) and 3 (5.56%) of these regained ovarian function within 2 years, and this was significantly lower in those who were elder (χ²=24.42, 54.97, both P<0.01). In this retrospective study, 19 patients of median age 51.08 years (48.00 to 54.25 years) with hormone receptor positive high-risk breast cancer who had median 9 months (2 to 21 months) of CIA were treated with aromatase inhibitor (AI). None regained ovarian function with a median of 32 months (8 to 68 months) follow-up.

For breast cancer patients with CIA age ≤45, AI should be avoided due to the high risk of OFR. For breast cancer patients age ≥51 who have at least 9 months of CIA, AI can be chosen with monitoring ovarian function regularly.