Abstract
Objective: To compare antimüllerian hormone (AMH) patterns by cancer status and treatment exposures across 6 years after incident breast cancer using administrative data. Design: In a cross-sectional design, AMH levels in patients who developed incident breast cancer between ages 15–39 years during 2005–2019 were matched 1:10 to levels in females without cancer in the OptumLabs Data Warehouse. Modeled AMH patterns were compared among cyclophosphamide-based chemotherapy, non-cyclophosphamide-based chemotherapy, no chemotherapy, and no breast cancer groups. Setting: Commercially insured females in the United States. Patient(s): Females with and without breast cancer. Exposure(s): Breast cancer, cyclophosphamide- and non-cyclophosphamide-based chemotherapy. Main Outcome Measure(s): AMH levels. Result(s): A total of 233 patients with breast cancer (mean age, 34 years; standard deviation, 3.7 years) contributed 278 AMH levels over a median of 2 years (range, 0–6.7 years) after diagnosis; 52% received cyclophosphamide-based chemotherapy, 17% received non-cyclophosphamide-based chemotherapy (80% platinum-based), and 31% received no chemotherapy. A total of 2,777 matched females without cancer contributed 2,780 AMH levels. The pattern of AMH levels differed among the 4 groups. Among females without cancer and breast cancer survivors who did not undergo chemotherapy, AMH declined linearly over time. In contrast, among those who received cyclophosphamide-based and noncyclophosphamide-based chemotherapy, a nonlinear pattern of AMH level of initial fall during chemotherapy, followed by an increase over 2–4 years, and then by a plateau over 1–2 years before a decline was observed. Conclusion(s): In breast cancer survivors, AMH levels from administrative data supported ovarian toxicity of non-cyclophosphamide-based chemotherapy in breast cancer and efficiently depicted the timing and duration of changes in ovarian reserve to reflect the residual reproductive lifespan.
Original language | English (US) |
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Pages (from-to) | 1047-1056 |
Number of pages | 10 |
Journal | Fertility and sterility |
Volume | 117 |
Issue number | 5 |
DOIs | |
State | Published - May 2022 |
Keywords
- AMH
- breast cancer
- cyclophosphamide
- ovarian reserve
- platinum
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynecology