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Impact of breast cancer on anti-mullerian hormone levels in young women

  • Epidemiology
  • Published:
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An Erratum to this article was published on 28 March 2013

Abstract

Young women with breast cancer face treatments that impair ovarian function, but it is not known if malignancy itself impacts ovarian reserve. As more breast cancer patients consider future fertility, it is important to determine if ovarian reserve is impacted by cancer, prior to any therapeutic intervention. A cross-sectional study was conducted comparing if ovarian reserve, as measured by anti-mullerian hormone (AMH), follicle stimulating hormone (FSH), and inhibin B (inhB), differed between 108 women with newly diagnosed breast cancer and 99 healthy women without breast cancer. Breast cancer participants were ages 28–44 and were recruited from two clinical breast programs. Healthy women ages 30–44 without a history of infertility were recruited from gynecology clinics and the community. The median age (interquartile range) was 40.2(5.5) years for breast cancer participants and 33.0(4.6) years for healthy controls. The unadjusted geometric mean AMH levels (SD) for breast cancer participants and controls were 0.66(3.6) and 1.1(2.9) ng/mL, respectively. Adjusting for age, body mass index, gravidity, race, menstrual pattern, and smoking, mean AMH levels were not significantly different between breast cancer participants and healthy controls (0.85 vs. 0.76 ng/mL, p = 0.60). FSH and inhB levels did not differ by breast cancer status. In exploratory analysis, the association between AMH and breast cancer status differed by age (p-interaction = 0.02). AMH may be lower with breast cancer status in women older than 37. In younger women, AMH levels did not differ significantly by breast cancer status. Among the youngest of breast cancer patients, ovarian reserve as measured by AMH, FSH, and inhibin B did not differ significantly from healthy women of similar age. In older breast cancer patients, ovarian reserve may be adversely impacted by cancer status. These findings support the potential success and need for fertility preservation strategies prior to institution of cancer treatment.

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Acknowledgments

We are grateful to Minya Pu, MS, for her guidance in graph generation. The study was funded by the National Institute of Child Health and Human Development (HD058799 [IS], HD060229 [AS]) and the American Cancer Society (MRSG-08-110-01-CCE [IS]).

Conflict of interest

Anne Steiner has been a consultant for Roche Diagnostics. Angela DeMichele has been a consultant for Pfizer.

Ethical standards

The study complied with the current laws of the United States.

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Authors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility and Moores UCSD Cancer Center, University of California San Diego, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-0901, USA

    H. I. Su, S. W. Flatt & L. Natarajan

  2. Center of Clinical Epidemiology and Biostatistics and Abramson Cancer Center, University of Pennsylvania, 3 West Pavilion, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA

    A. DeMichele

  3. Division of Reproductive Endocrinology and Infertility, University of North Carolina Chapel Hill, 4001 Old Clinic Building, Campus Box 7570, Chapel Hill, NC, 27599, USA

    A. Z. Steiner

Authors
  1. H. I. Su
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  2. S. W. Flatt
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  3. L. Natarajan
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  4. A. DeMichele
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  5. A. Z. Steiner
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Correspondence to H. I. Su.

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Su, H.I., Flatt, S.W., Natarajan, L. et al. Impact of breast cancer on anti-mullerian hormone levels in young women. Breast Cancer Res Treat 137, 571–577 (2013). https://doi.org/10.1007/s10549-012-2361-5

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  • DOI: https://doi.org/10.1007/s10549-012-2361-5

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