Multidisciplinary Journal of Science and Technology

ENDOCRINE PERTURBATIONS INDUCED BY ADJUVANT CHEMOTHERAPY IN NON-LUMINAL B BREAST CANCER WITH LYMPH NODE INVOLVEMENT POST-ORGAN-PRESERVING SURGERY

SOBIRJONOVA Z.A

Department of General Oncology, first-year master's students

IKROMOVA G.N

Department of General Oncology, first-year master's students

QADAMBOY M.M

Department of General Oncology, first-year master's students

MALIKOVA L.N

Department of General Oncology, first-year master's students

Keywords: Non-luminal B breast cancer, adjuvant chemotherapy, premature ovarian insufficiency, endocrine disruption, lymph node involvement, organ-preserving surgery, gonadotropin-releasing hormone agonists, bone mineral density, fertility preservation, aromatase inhibitors

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Abstract

Adjuvant chemotherapy is integral to the management of non-luminal B breast cancer subtypes—luminal A, HER2-positive, and triple-negative breast cancer (TNBC)—with lymph node involvement following organ-preserving surgery. This study elucidates the multifaceted endocrine disruptions precipitated by cytotoxic regimens, including cyclophosphamide, methotrexate, and fluorouracil (CMF), anthracyclines, and taxanes, focusing on ovarian function, hormonal homeostasis, and skeletal integrity. In premenopausal women, chemotherapy frequently induces premature ovarian insufficiency (POI), characterized by elevated follicle-stimulating hormone (FSH), diminished estradiol, and resultant amenorrhea, with profound implications for fertility and quality of life. Gonadotropin-releasing hormone (GnRH) agonists mitigate these effects by suppressing ovarian activity. In postmenopausal women, chemotherapy synergizes with aromatase inhibitors (AIs) to exacerbate bone mineral density (BMD) loss, elevating fracture risk. This review integrates molecular, clinical, and epidemiological data to delineate these endocrine sequelae, emphasizing personalized therapeutic strategies, fertility preservation, and bone health interventions. Two tables summarize key endocrine outcomes and management approaches, underscoring the necessity for tailored survivorship care in this cohort.

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