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Abstract:
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A common adjuvant treatment for premenopausal breast cancer patients is chemotherapy, which has been shown to cause premature menopause and infertility with serious consequences to quality of life. As an alternative, luteinizing-hormone-releasing hormone (LHRH) agonists induce temporary ovarian function suppression (OFS), and have the potential to preserve fertility after treatment. However, little is known about whether patients with a lower underlying degree of OFS (i.e. higher estrogen production) after taking LHRH agonists are at a higher risk for late breast cancer events. In this paper, we propose a latent class joint model (LCJM), where the available surrogates for the latent variable involve masked cause and cured proportions, to investigate the association between OFS and DFS. We employ a likelihood approach and the EM algorithm, and present results from a breast cancer study.
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