Long-term antimüllerian hormone patterns differ by cancer treatment exposures in young breast cancer survivors.

Journal Article (Journal Article)

Objective

To compare antimüllerian hormone (AMH) patterns by cancer status and treatment exposures across 6 years after incident breast cancer using administrative data.

Design

In a cross-sectional design, AMH levels in patients who developed incident breast cancer between ages 15-39 years during 2005-2019 were matched 1:10 to levels in females without cancer in the OptumLabs Data Warehouse. Modeled AMH patterns were compared among cyclophosphamide-based chemotherapy, non-cyclophosphamide-based chemotherapy, no chemotherapy, and no breast cancer groups.

Setting

Commercially insured females in the United States.

Patient(s)

Females with and without breast cancer.

Exposure(s)

Breast cancer, cyclophosphamide- and non-cyclophosphamide-based chemotherapy.

Main outcome measure(s)

AMH levels.

Result(s)

A total of 233 patients with breast cancer (mean age, 34 years; standard deviation, 3.7 years) contributed 278 AMH levels over a median of 2 years (range, 0-6.7 years) after diagnosis; 52% received cyclophosphamide-based chemotherapy, 17% received non-cyclophosphamide-based chemotherapy (80% platinum-based), and 31% received no chemotherapy. A total of 2,777 matched females without cancer contributed 2,780 AMH levels. The pattern of AMH levels differed among the 4 groups. Among females without cancer and breast cancer survivors who did not undergo chemotherapy, AMH declined linearly over time. In contrast, among those who received cyclophosphamide-based and noncyclophosphamide-based chemotherapy, a nonlinear pattern of AMH level of initial fall during chemotherapy, followed by an increase over 2-4 years, and then by a plateau over 1-2 years before a decline was observed.

Conclusion(s)

In breast cancer survivors, AMH levels from administrative data supported ovarian toxicity of non-cyclophosphamide-based chemotherapy in breast cancer and efficiently depicted the timing and duration of changes in ovarian reserve to reflect the residual reproductive lifespan.

Full Text

Duke Authors

Cited Authors

  • Zhou, B; Kwan, B; Desai, MJ; Nalawade, V; Ruddy, KJ; Nathan, PC; Henk, HJ; Murphy, JD; Whitcomb, BW; Su, HI

Published Date

  • May 2022

Published In

Volume / Issue

  • 117 / 5

Start / End Page

  • 1047 - 1056

PubMed ID

  • 35216831

Pubmed Central ID

  • PMC9081208

Electronic International Standard Serial Number (EISSN)

  • 1556-5653

International Standard Serial Number (ISSN)

  • 0015-0282

Digital Object Identifier (DOI)

  • 10.1016/j.fertnstert.2022.01.016

Language

  • eng