Antimullerian hormone and inhibin B are hormone measures of ovarian function in late reproductive-aged breast cancer survivors

Authors

  • H. Irene Su MSCE, MD,

    Corresponding author
    1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    2. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    • Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, 3701 Market Street, Suite 801, Philadelphia, PA 19104===

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    • Fax: (215) 349-5512

  • Mary D. Sammel ScD,

    1. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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  • Jamie Green MD,

    1. Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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  • Luke Velders BS,

    1. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    2. Rowan Breast Center, Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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  • Corrie Stankiewicz MD,

    1. Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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  • Jennifer Matro MD,

    1. Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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  • Ellen W. Freeman PhD,

    1. Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    2. Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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  • Clarisa R. Gracia MSCE, MD,

    1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    2. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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  • Angela DeMichele MSCE, MD

    1. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    2. Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    3. Rowan Breast Center, Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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Abstract

BACKGROUND:

In late reproductive-aged breast cancer survivors, there is a need for real-time biomarkers of postchemotherapy ovarian function. The objective was to determine whether antimullerian hormone (AMH) and inhibin B are such biomarkers. The authors tested whether AMH and inhibin B were impacted by breast cancer treatment by comparing cancer survivors to age-matched control women and determined the association between these hormones and postchemotherapy menstrual pattern.

METHODS:

Breast cancer patients (n = 127) with American Joint Committee on Cancer stage I to III disease who were premenopausal at diagnosis were enrolled postchemotherapy and observed. The primary endpoint was chemotherapy-related amenorrhea (CRA) (≥12 months of amenorrhea after chemotherapy). Matched pair analyses compared AMH, inhibin B, and follicle-stimulating hormone (FSH) levels between cancer and age-matched control subjects. Associations between hormones, CRA status, and change in CRA status over time were assessed.

RESULTS:

The median age of the patients at chemotherapy was 43.2 years (range, 26.7-57.8 years). At enrollment, median follow-up since chemotherapy was 2.1 years, and 55% of subjects had CRA. Compared with age-matched controls, cancer subjects had significantly lower AMH (P = .004) and inhibin B (P < .001) and higher FSH (P < .001). AMH (P = .002) and inhibin B (P = .001) were found to be significantly associated with risk of CRA, even after controlling for FSH. AMH was significantly lower (P = .03) and FSH was significantly higher (P = .04) in menstruating subjects who developed subsequent CRA.

CONCLUSIONS:

AMH and inhibin B are 2 additional measures of postchemotherapy ovarian function in late reproductive-aged breast cancer survivors. With further research and validation, these hormones may supplement limited current tools for assessing and predicting postchemotherapy ovarian function. Cancer 2010. © 2009 American Cancer Society.

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