Cong Xue1, Wenwen Wei1, Peng Sun1, Wei Zheng2, Xiaoju Diao1, Fei Xu1, Jiajia Huang1, Xin An1, Wen Xia1, Ruoxi Hong1, Kuikui Jiang1, Riqing Huang1, Zhongyu Yuan1, Shusen Wang1, Anhua Li2, Ruhai Zou2, Yanxia Shi3. 1. Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Dongfeng Road East 651#, Guangzhou, 510060, China. 2. Department of Ultrasound and Electrocardiogram, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China. 3. Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Dongfeng Road East 651#, Guangzhou, 510060, China. shiyx@sysucc.org.cn.
Abstract
PURPOSE: Ovarian function is important for optimizing endocrine treatment in patients with hormone receptor-positive (HR+) early breast cancer (eBC). The aim of the study was to determine whether patients' pretreatment levels of anti-Mullerian hormone (AMH) were associated with menses status after chemotherapy and to build a predictive nomogram model for amenorrhea in women with HR+ eBC. METHODS: Between August 2013 and December 2014, 120 premenopausal patients with HR+ eBC were included retrospectively. The associations among age, prechemotherapy levels of AMH, follicle-stimulating hormone (FSH),and estradiol (E2) and the 2-year postchemotherapy menses status were analyzed. We determined the cutoff values of hormone levels by using the biostatistical tool (Cutoff Finder). A novel nomogram was established to predict the 2-year amenorrhea status based on the logistic analysis. Concordance index (C-index) was used to validate the capacity. RESULTS: One hundred nine women (90.8%) experienced amenorrhea after chemotherapy. AMH < 0.965 ng/ml predicted amenorrhea at 2 years (AUC 0.84, sensitivity 74% and specificity 81.8%), independent of age. The predictive nomogram based on age and pretreatment AMH and FSH levels was developed to predict the probability of 2-year postchemotherapy amenorrhea with a C-index of 0.88 (95% CI 0.84-0.91). CONCLUSIONS: In premenopausal patients with HR+ eBC, prechemotherapy AMH concentration was associated with the patient's 2-year amenorrhea status, independent of age. The nomogram model based on age and pretreatment AMH and FSH levels accurately predicted the 2-year amenorrhea status.
PURPOSE: Ovarian function is important for optimizing endocrine treatment in patients with hormone receptor-positive (HR+) early breast cancer (eBC). The aim of the study was to determine whether patients' pretreatment levels of anti-Mullerian hormone (AMH) were associated with menses status after chemotherapy and to build a predictive nomogram model for amenorrhea in women with HR+ eBC. METHODS: Between August 2013 and December 2014, 120 premenopausal patients with HR+ eBC were included retrospectively. The associations among age, prechemotherapy levels of AMH, follicle-stimulating hormone (FSH),and estradiol (E2) and the 2-year postchemotherapy menses status were analyzed. We determined the cutoff values of hormone levels by using the biostatistical tool (Cutoff Finder). A novel nomogram was established to predict the 2-year amenorrhea status based on the logistic analysis. Concordance index (C-index) was used to validate the capacity. RESULTS: One hundred nine women (90.8%) experienced amenorrhea after chemotherapy. AMH < 0.965 ng/ml predicted amenorrhea at 2 years (AUC 0.84, sensitivity 74% and specificity 81.8%), independent of age. The predictive nomogram based on age and pretreatment AMH and FSH levels was developed to predict the probability of 2-year postchemotherapy amenorrhea with a C-index of 0.88 (95% CI 0.84-0.91). CONCLUSIONS: In premenopausal patients with HR+ eBC, prechemotherapy AMH concentration was associated with the patient's 2-year amenorrhea status, independent of age. The nomogram model based on age and pretreatment AMH and FSH levels accurately predicted the 2-year amenorrhea status.
Entities:
Keywords:
Amenorrhea; Anti-Mullerian hormone; Breast cancer; Chemotherapy; Nomogram
Authors: Jae Jun Shin; Young Min Choi; Jong Kwan Jun; Kyung-Hun Lee; Tae-Yong Kim; Wonshik Han; Seock-Ah Im Journal: J Breast Cancer Date: 2020-05-11 Impact factor: 3.588
Authors: Richard A Anderson; Tom W Kelsey; Anne Perdrix; Nathalie Olympios; Orianne Duhamel; Matteo Lambertini; Florian Clatot Journal: Breast Cancer Res Treat Date: 2022-01-08 Impact factor: 4.624
Authors: Kathryn J Ruddy; Daniel J Schaid; Anthony Batzler; Reena S Cecchini; Ann H Partridge; Aaron Norman; Louis Fehrenbacher; Elizabeth A Stewart; Emanuel Trabuco; Elizabeth Ginsburg; Fergus J Couch; Peter A Fasching; Celine Vachon; Patricia A Ganz Journal: J Natl Cancer Inst Date: 2021-08-02 Impact factor: 13.506