Systemic chemotherapy (SC) has a negative effect on ovarian functions. The aim of this study is to investigate the effect of SC on anti-müllerian hormone (AMH) levels, antral follicle counts (AFC) and ovarian volumes (MOV) in patients with BC.
The demographic, clinical and pathological features of premenopausal breast cancer (BC) patients who were operated in the Istanbul Florence Nightingale Hospital were recorded. AMH levels, AFC and MOV measurements were performed before and after adjuvant SC in 3-month periods. The patients who did not have menstruel cycles for 6 months or longer had been classified as chemotherapy induced amenorrhea (CIA). The effects of different chemotherapy regimens on AMH, AFC and MOV in terms menstruel cycles resumption and CIA were investigated.
Seventy one patients were eligible for the study, and median age of them was 38 years (ranged from 23 to 51 years). Median follow-up was 37 months (ranged from 20 to 51 months), CIA developed in 62% of patients. AMH, AFC, and MOV significantly decreased one year after SC (p < 0.0001). AMH before chemotherapy (median: 1,520 vs 0,755, p = 0.001), at the end of first year (median: 0,073 vs 0,010 ng/ml, p = 0.030) and pre-treatment AFC (median12 vs 4,50, p = 0.026) was lower in patients with CIA comparing those without CIA. In multivariate logistic regression analysis, AMH levels (OR:0.273, 95%: 0.102 – 0.733, p = 0.010) and AFC (OR: 1,180, 95% CI; 1,016-1,369, p = 0.030) before SC were the most valuable and earliest factors to predict CIA. There were no significant relationships between age of the patients (≤30vs>30 ), BMI (30vs> 30), SC regimen and number of cycles (4 vs > 4) and CIA (p > 0.05). 254P muitivariet analyses with logistic regrettion for CIAUNIVARIET MULTIVARIET OR 95% CI OR 95% CI ER 0,19 0,038 - 0,891 0,035 0,002 0,000 - 0,111 0,002 HER 2 0.80 0,435 - 2,936 1,130 ALND PERFORMED 1,75 0,653 - 4,702 0,265 AMH-1 0,64 0,454 - 0,914 0,014 0,273 0,102 - 0,733 0,010 AMH-5 0,23 0,063 - 0,812 0,023 0,009 0,000 - 0,754 0,037 AFC-1 0,87 0,780 - 0,961 0,007 0,735 0,572 - 0,944 0,016 AFC-5 0,93 0,741 - 1,165 0,527 MOV-1 1,00 0,987 - 1,021 0,686 MOV-5 0,98 0,854 - 1,158 0,790 TAXANE/W&İTHOUTTAXANE 0,71 0,267 - 1,910 0,503 TC/AC 0,85 0,209 - 3,491 0,825 AGE 35 4,66 1,613 - 13,498 0,004 CHEMONUMBER 0,24 0,080 - 0,766 0,017 BMI 25 2,57 0,929 - 7,118 0,069
SC significantly decreases AMH and AFC values independently of chemotherapeutic agents in patients with BC. The low AMH levels and less AFC before SC may predict CIA.
İstanbul Demiroğlu Bilim University.
Has not received any funding.
All authors have declared no conflicts of interest.