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Poster Display session 2

1570 - Anti-mullerian hormone (AMH) levels and antral follicle counts (AFC) may predict ovarian reserves before systemic chemotherapy (SC) in women with breast cancer(BC); a prospective clinical study

Date

29 Sep 2019

Session

Poster Display session 2

Topics

Tumour Site

Breast Cancer

Presenters

Cetin Ordu

Citation

Annals of Oncology (2019) 30 (suppl_5): v55-v98. 10.1093/annonc/mdz240

Authors

C. Ordu1, F. Gachayev2, F. Elbuken3, B. Baysal2, K.N. Pilanci4, G. Alco5, A.S. Ilgun6, M. Ucuncu2, A. Ozturk7, Z. Erdogan8, F. Agacayak9, G. Ozdem10, T. Kayan11, T. Uyar12, E. Hocaoğlu2, G. Soybir13, F. Aktepe14, V. Ozmen15

Author affiliations

  • 1 Medical Oncology, Ozel Gayrettepe Florence Nightingale Hospital, 34346 - Istanbul/TR
  • 2 Surgical Oncology, Istanbul FN Hospital, 34450 - istanbul/TR
  • 3 Radiology, Gayrettepe Florence Nightingale Hospiatl, 34538 - Istanbul/TR
  • 4 Medical Oncology, Memorial Hospital, 34538 - Istanbul/TR
  • 5 Radiation Oncology, Gayrettepe Florence Nightingale Hospital, 34538 - Istanbul/TR
  • 6 Surgery, Taksim Hospital, 34538 - Istanbul/TR
  • 7 Surgery, Biruni University, 34538 - Istanbul/TR
  • 8 Physical Therapy And Rehabilitation, Bilim University, 34538 - Istanbul/TR
  • 9 Radiology, Istanbul Florence Hospital, 34538 - Istanbul/TR
  • 10 Physicology, Ozel Gayrettepe Florence Nightingale Hospital, 34450 - istanbul/TR
  • 11 Nutrition, Bilim University, 34538 - Istanbul/TR
  • 12 Physical Therapy And Rehabilitation, İstanbul Bilgi Universirty, 34400 - İstanbul/TR
  • 13 Surgery, Memorial Hospital, 34538 - Istanbul/TR
  • 14 Pathology, Gayrettepe Florence Nightingale Hospital, 34538 - Istanbul/TR
  • 15 Surgery, Istanbul University - Faculty of Medicine, 34093 - Istanbul/TR
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Resources

Abstract 1570

Background

Systemic chemotherapy (SC) has a negative effect on ovarian functions. The aim of this study is to investigate the effect of SC on anti-müllerian hormone (AMH) levels, antral follicle counts (AFC) and ovarian volumes (MOV) in patients with BC.

Methods

The demographic, clinical and pathological features of premenopausal breast cancer (BC) patients who were operated in the Istanbul Florence Nightingale Hospital were recorded. AMH levels, AFC and MOV measurements were performed before and after adjuvant SC in 3-month periods. The patients who did not have menstruel cycles for 6 months or longer had been classified as chemotherapy induced amenorrhea (CIA). The effects of different chemotherapy regimens on AMH, AFC and MOV in terms menstruel cycles resumption and CIA were investigated.

Results

Seventy one patients were eligible for the study, and median age of them was 38 years (ranged from 23 to 51 years). Median follow-up was 37 months (ranged from 20 to 51 months), CIA developed in 62% of patients. AMH, AFC, and MOV significantly decreased one year after SC (p < 0.0001). AMH before chemotherapy (median: 1,520 vs 0,755, p = 0.001), at the end of first year (median: 0,073 vs 0,010 ng/ml, p = 0.030) and pre-treatment AFC (median12 vs 4,50, p = 0.026) was lower in patients with CIA comparing those without CIA. In multivariate logistic regression analysis, AMH levels (OR:0.273, 95%: 0.102 – 0.733, p = 0.010) and AFC (OR: 1,180, 95% CI; 1,016-1,369, p = 0.030) before SC were the most valuable and earliest factors to predict CIA. There were no significant relationships between age of the patients (≤30vs>30 ), BMI (30vs> 30), SC regimen and number of cycles (4 vs > 4) and CIA (p > 0.05).Table:

254P muitivariet analyses with logistic regrettion for CIA

UNIVARIETMULTIVARIET
OR95% CIOR95% CI
ER0,190,038-0,8910,0350,0020,000- 0,1110,002
HER 20.800,435-2,9361,130
ALND PERFORMED1,750,653-4,7020,265
AMH-10,640,454-0,9140,0140,2730,102- 0,7330,010
AMH-50,230,063-0,8120,0230,0090,000- 0,7540,037
AFC-10,870,780-0,9610,0070,7350,572- 0,9440,016
AFC-50,930,741-1,1650,527
MOV-11,000,987-1,0210,686
MOV-50,980,854-1,1580,790
TAXANE/W&İTHOUTTAXANE0,710,267-1,9100,503
TC/AC0,850,209-3,4910,825
AGE 354,661,613-13,4980,004
CHEMONUMBER0,240,080-0,7660,017
BMI 252,570,929-7,1180,069

Conclusions

SC significantly decreases AMH and AFC values independently of chemotherapeutic agents in patients with BC. The low AMH levels and less AFC before SC may predict CIA.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

İstanbul Demiroğlu Bilim University.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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