Tess V Clendenen1, Wenzhen Ge1, Karen L Koenig1, Yelena Afanasyeva1, Claudia Agnoli2, Elizabeth Bertone-Johnson3, Louise A Brinton4, Farbod Darvishian5,6, Joanne F Dorgan7, A Heather Eliassen8, Roni T Falk4, Göran Hallmans9, Susan E Hankinson3,8, Judith Hoffman-Bolton10, Timothy J Key11, Vittorio Krogh2, Hazel B Nichols12, Dale P Sandler13, Minouk J Schoemaker14, Patrick M Sluss15, Malin Sund16, Anthony J Swerdlow14,17, Kala Visvanathan10,18, Mengling Liu1,6, Anne Zeleniuch-Jacquotte1,6. 1. Department of Population Health, New York University School of Medicine, New York, NY, USA. 2. Epidemiology and Prevention Unit, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy. 3. Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA. 4. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. 5. Pathology, New York University School of Medicine, New York, NY, USA. 6. Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA. 7. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA. 8. Department of Epidemiology, Harvard T.H. Chan School of Public Health, and Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 9. Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden. 10. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 11. Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. 12. Department of Epidemiology, University of North Carolina, Chapel Hill; NC, USA. 13. Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA. 14. Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK. 15. Department of Pathology, Harvard Medical School, Boston, MA, USA. 16. Department of Surgery, Umeå University Hospital, Umeå, Sweden. 17. Division of Breast Cancer Research, The Institute of Cancer Research, London, UK. 18. Sidney Kimmel Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Abstract
CONTEXT: We previously reported that anti-Müllerian hormone (AMH), a marker of ovarian reserve, is positively associated with breast cancer risk, consistent with other studies. OBJECTIVE: This study assessed whether risk factors for breast cancer are correlates of AMH concentration. METHODS: This cross-sectional study included 3831 healthy premenopausal women (aged 21-57, 87% aged 35-49) from 10 cohort studies among the general population. RESULTS: Adjusting for age and cohort, AMH positively associated with age at menarche (P < 0.0001) and parity (P = 0.0008) and inversely associated with hysterectomy/partial oophorectomy (P = 0.0008). Compared with women of normal weight, AMH was lower (relative geometric mean difference 27%, P < 0.0001) among women who were obese. Current oral contraceptive (OC) use and current/former smoking were associated with lower AMH concentration than never use (40% and 12% lower, respectively, P < 0.0001). We observed higher AMH concentrations among women who had had a benign breast biopsy (15% higher, P = 0.03), a surrogate for benign breast disease, an association that has not been reported. In analyses stratified by age (<40 vs ≥40), associations of AMH with body mass index and OCs were similar in younger and older women, while associations with the other factors (menarche, parity, hysterectomy/partial oophorectomy, smoking, and benign breast biopsy) were limited to women ≥40 (P-interaction < 0.05). CONCLUSION: This is the largest study of AMH and breast cancer risk factors among women from the general population (not presenting with infertility), and it suggests that most associations are limited to women over 40, who are approaching menopause and whose AMH concentration is declining.
CONTEXT: We previously reported that anti-Müllerian hormone (AMH), a marker of ovarian reserve, is positively associated with breast cancer risk, consistent with other studies. OBJECTIVE: This study assessed whether risk factors for breast cancer are correlates of AMH concentration. METHODS: This cross-sectional study included 3831 healthy premenopausal women (aged 21-57, 87% aged 35-49) from 10 cohort studies among the general population. RESULTS: Adjusting for age and cohort, AMH positively associated with age at menarche (P < 0.0001) and parity (P = 0.0008) and inversely associated with hysterectomy/partial oophorectomy (P = 0.0008). Compared with women of normal weight, AMH was lower (relative geometric mean difference 27%, P < 0.0001) among women who were obese. Current oral contraceptive (OC) use and current/former smoking were associated with lower AMH concentration than never use (40% and 12% lower, respectively, P < 0.0001). We observed higher AMH concentrations among women who had had a benign breast biopsy (15% higher, P = 0.03), a surrogate for benign breast disease, an association that has not been reported. In analyses stratified by age (<40 vs ≥40), associations of AMH with body mass index and OCs were similar in younger and older women, while associations with the other factors (menarche, parity, hysterectomy/partial oophorectomy, smoking, and benign breast biopsy) were limited to women ≥40 (P-interaction < 0.05). CONCLUSION: This is the largest study of AMH and breast cancer risk factors among women from the general population (not presenting with infertility), and it suggests that most associations are limited to women over 40, who are approaching menopause and whose AMH concentration is declining.
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