Abstract:
Objective To explore the predictive value of serum markers, such as the anti-Mullerian hormone (AMH), for ovarian failure (OVF) in premenopausal early breast cancer patients with chemotherapy-induced amenorrhea, in order to optimize adjuvant therapy and protect fertility.
Methods Prospectively, 60 premenopausal patients with early breast cancer receiving cyclophosphamide-containing chemotherapy in The Third Affiliated Hospital of Guangzhou Medical University from April 2016 to December 2018 were analyzed. The dynamic changes of serum AMH, follicle stimulating hormone (FSH), and estradiol (E2) levels were monitored before and after chemotherapy to analyze their predictive value for OVF 24 months after chemotherapy.
Results Pre-chemotherapy AMH exhibited a good predictive value for OVF 24 months after chemotherapy with an area under curve (AUC) of 0.837 95% confidence interval (CI): 0.719–0.920 and an AUC was 0.924 (95% CI: 0.826–0.977) for age combined with pre-chemotherapy AMH and other hormone levels; pre-chemotherapy AMH≤1.05 ng/mL, AMH≤0.56 ng/mL after 1 cycle, FSH >25.01 U/L at 3–6 months after chemotherapy and age at diagnosis >37 years showed a 100% negative predictive value.
Conclusions AMH combined with E2 and FSH detection is valuable in early identification of OVF after chemotherapy in premenopausal breast cancer patients. Therefore, we posit that AMH be included in the routine testing prior to chemotherapy .