title: Antimullerian hormone and inhibin B are hormone measures of ovarian function in late reproductive-aged breast cancer survivors.
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) (> or = 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.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. hisu@ucsd.edu
authors.forename: H Irene
authors.initials: HI
authors.lastname: Su
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Jamie
authors.initials: J
authors.lastname: Green
authors.forename: Luke
authors.initials: L
authors.lastname: Velders
authors.forename: Corrie
authors.initials: C
authors.lastname: Stankiewicz
authors.forename: Jennifer
authors.initials: J
authors.lastname: Matro
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Freeman
authors.forename: Clarisa R
authors.initials: CR
authors.lastname: Gracia
authors.forename: Angela
authors.initials: A
authors.lastname: DeMichele
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced*; D054304:Anti-Mullerian Hormone / Q000097:blood*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007265:Inhibins / Q000097:blood*; D008875:Middle Aged; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced*; D017741:Survivors; D013629:Tamoxifen / Q000494:pharmacology
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; C422364:inhibin B; D013629:Tamoxifen; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone