Senologie - Zeitschrift für Mammadiagnostik und -therapie 2018; 15(02): e14-e15
DOI: 10.1055/s-0038-1651709
Abstracts
Georg Thieme Verlag KG Stuttgart · New York

Changes in hormone levels (E2, FSH, AMH) and fertility of young women treated with neo-/adjuvant chemotherapy (CT) for early breast cancer (EBC)

J Furlanetto
1   German Breast Group, Neu-Isenburg, Deutschland
,
C Thode
2   Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, medizinische Mikrobiologie und Immunologie, Göttingen, Deutschland
,
J Huober
3   Universitätsklinikum Ulm, Ulm, Deutschland
,
C Denkert
4   Charité – Universitätsmedizin, Berlin, Deutschland
,
M Bassy
2   Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, medizinische Mikrobiologie und Immunologie, Göttingen, Deutschland
,
C Hanusch
5   Klinikum zum Roten Kreuz, München, Deutschland
,
C Jackisch
6   SANA Klinikum, Offenbach, Deutschland
,
S Kümmel
7   Kliniken Essen-Mitte, Essen, Deutschland
,
A Schneeweiss
8   Nationales Centrum für Tumorerkrankungen, Heidelberg, Deutschland
,
M Untch
9   HELIOS Klinikum Berlin Buch, Berlin, Deutschland
,
PA Fasching
10   Universitätsklinikum Erlangen, Erlangen, Deutschland
,
T Karn
11   Universitätsklinikum Frankfurt, Frankfurt, Deutschland
,
F Marmé
12   Universitätsklinikum Heidelberg, Heidelberg, Deutschland
,
M van Mackelenbergh
13   Universitätsklinikums Schleswig-Holstein, Kiel, Deutschland
,
V Müller
14   Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
,
C Schem
15   Mammazentrum Hamburg am Krankenhaus Jerusalem, Hamburg, Deutschland
,
G von Minckwitz
1   German Breast Group, Neu-Isenburg, Deutschland
,
D Strik
16   Endokrinologikum, Berlin, Deutschland
,
V Nekljudova
1   German Breast Group, Neu-Isenburg, Deutschland
,
S Loibl
1   German Breast Group, Neu-Isenburg, Deutschland
› Author Affiliations
Further Information

Publication History

Publication Date:
22 May 2018 (online)

Also available at
 

Background:

We previously demonstrated that the majority of women ≤45 years experienced chemotherapy-induced ovarian failure (CIOF) after CT for EBC. Age, CT regimen, duration, dose-density influenced the rate of CIOF. Regain of premenopausal FSH/estradiol levels after chemotherapy is not equivalent to fertility restoration. The Anti-Muellerian Hormone (AMH) seems more accurate in predicting the ovarian reserve.

Methods:

740 patients aged ≤45yrs treated with anthracycline/taxane-based CT for EBC from 4 German neoadjuvant/adjuvant trials were included. FSH, estradiol, AMH were centrally assessed before CT (N = 740), end of treatment (n = 740), 6 (n = 177), 12 (n = 113), 18 (n = 69), 24 (n = 47) months after EOT. Postmenopausal levels were defined as FSH> 12.4IU/l, estradiol< 52.2 ng/l; fertile AMH as ≥0.22 ng/ml. Regain of premenopausal levels was defined as the time-point from EOT to premenopausal FSH and E2 level regain.

Results:

Median age was 40 [21 – 45] yrs; 41.1% had BMI ≥25. Before chemotherapy 14.2% of patients had non-fertile AMH despite premenopausal hormone levels compared to 77.3% of patients with postmenopausal levels (p < 0.001); at EOT 77.4% vs. 99.8% (p < 0.001); at 6 months 82.1% vs. 100% (p < 0.001); at 12 months 80.7% vs. 98.4% (p = 0.002); at 18 months 66.7% vs. 100% (p < 0.001); at 24 months 72.4% vs. 100% (p = 0.017). Of 147 patients with postmenopausal hormone levels at EOT, 32.7% (95%CI 25.7%-40.9%) regained premenopausal hormone levels within 6 months, 51.0% (95%CI 42.3%-60.4%) within 12 months, 66.6% (95%CI 55.2%-77.6%) within 18 months and 69.9% (95%CI 57.8%-81.3%) within 24 months.

Conclusions:

Nearly 70% of women regain premenopausal hormone levels within 2 years after CT end, but only less than one-third maintain their fertility potential as predicted by AMH.