Is Anti-Müllerian Hormone a Marker of Ovarian Reserve in Young Breast Cancer Patients Receiving a GnRH Analog during Chemotherapy?

Breast Care ◽  
2021 ◽  
pp. 1-6
Author(s):  
Rosalba Torrisi ◽  
Vera Basilico ◽  
Laura Giordano ◽  
Michele Caruso ◽  
Antonino Musolino ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Ovarian Reserve ◽  
Premenopausal Women ◽  
Secondary Endpoint ◽  
Breast Cancer Patients ◽  
Gnrh Analog ◽  
Concurrent Administration ◽  
Percent Change ◽  
Young Breast Cancer

Introduction: Anti-Müllerian hormone (AMH) is the most reliable biomarker of ovarian reserve; however, its role in predicting ovarian recovery after chemotherapy is unclear. Administration of a GnRH analog (GnRHa) during chemotherapy significantly reduces the ovarian failure rate and increases the pregnancy rate. The available data on the behavior of AMH during concurrent administration of chemotherapy and GnRHa are inconsistent. We investigated whether concurrent administration of triptorelin and adjuvant chemotherapy might reduce the expected drop of AMH. Methods: Eligible patients were premenopausal women aged <40 years, with a diagnosis of early breast cancer, and candidates to 4–8 cycles of adjuvant chemotherapy. Triptorelin (3.75 mg i.m.) was started before chemotherapy and administered every 4 weeks thereafter. The principal endpoint was the proportion of patients with an AMH percent change ≤50% between 12 months after chemotherapy and basal levels. The secondary endpoint was the proportion of patients achieving postchemotherapy AMH levels above the threshold of 0.2 ng/mL. Results: Fifty patients were enrolled, 31 of whom had blood samples available at baseline and 1 year after the end of chemotherapy. AMH decreased to nearly undetectable levels after chemotherapy and recovered after 12 months, but they did not exceed 1 tenth of the pretreatment levels. As for the secondary endpoint, 15 of the 31 patients recovered AMH levels above the threshold. Conclusions: This study did not reach its principal endpoint; however, the rate of 48% of patients who recovered AMH above threshold levels favorably compared with those in studies without concurrent GnRHa, supporting a better recovery of AMH with triptorelin.

scholarly journals Chemotherapy in Premenopausal Breast Cancer Patients

Breast Care ◽  
2015 ◽  
Vol 10 (5) ◽  
pp. 307-310 ◽  
Author(s):  
Ann H. Partridge
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Menopausal Status ◽  
Premenopausal Women ◽  
Optimal Strategies ◽  
Cytotoxic Chemotherapy ◽  
Breast Cancer Patients ◽  
Premenopausal Breast Cancer ◽  
Hormone Receptor Positive ◽  
Breast Cancer Outcomes

Evidence has long demonstrated that premenopausal women obtain the greatest benefit from adjuvant chemotherapy overall, with risk reduction increasing with decreasing age. The chemoendocrine effect of chemotherapy has only more recently been documented as impacting on outcomes for women with hormone receptor-positive breast cancer, and recent data have elucidated the optimal strategies for manipulating the menopausal status to improve disease outcomes, without necessarily including cytotoxic chemotherapy. Still, many premenopausal women will require adjuvant cytotoxic chemotherapy, and the effects of treatment on women diagnosed with breast cancer in the premenopausal setting can have important implications both on their breast cancer outcomes and on comorbidities and psychosocial outcomes. This article describes the most recent information and issues surrounding the indications, effects, and special considerations for adjuvant chemotherapy in premenopausal women with breast cancer, in an effort to inform their care.

The special concerns of young breast cancer patients before neo/adjuvant chemotherapy

The Breast ◽  
2018 ◽  
Vol 41 ◽  
pp. S30
Author(s):  
Katarzyna Pogoda ◽  
Agnieszka Jagiełło-Gruszfeld ◽  
Anna Niwińska ◽  
Maria Kowalska ◽  
Anna Górniak ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Neo Adjuvant Chemotherapy ◽  
Young Breast Cancer

scholarly journals Zoledronic Acid Prevents Bone Loss in Premenopausal Women Undergoing Adjuvant Chemotherapy for Early-Stage Breast Cancer

2008 ◽  
Vol 26 (29) ◽  
pp. 4739-4745 ◽  
Author(s):  
Dawn L. Hershman ◽  
Donald J. McMahon ◽  
Katherine D. Crew ◽  
Serge Cremers ◽  
Dinaz Irani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Zoledronic Acid ◽  
Adjuvant Chemotherapy ◽  
Bone Loss ◽  
Repeated Measures ◽  
Early Stage ◽  
Premenopausal Women ◽  
Phase Iii ◽  
Mineral Density ◽  
Percent Change

Purpose Adjuvant chemotherapy for breast cancer (BC) may be associated with increased rates of bone loss and decreased bone mineral density (BMD) and may lead to premature osteoporosis and increased fracture risk. We examined whether zoledronic acid (ZA) prevents bone loss in premenopausal women receiving chemotherapy for early-stage BC. Patients and Methods This study is a randomized, double-blind, multicenter, phase III trial comparing ZA (4 mg intravenously every 3 months) versus placebo for 1 year. Premenopausal women underwent serial BMD measurements before initiating chemotherapy and at 6 and 12 months. The primary outcome was percent change in lumbar spine (LS) BMD at 6 months. Secondary outcomes were percent change at any BMD site and markers of bone turnover at 12 months. Linear mixed model analysis for repeated measures was performed. Results Of 101 women who were randomly assigned and completed baseline evaluation, 96 completed the 6-month evaluation, and 85 completed the 12-month evaluation. Baseline characteristics were comparable between the groups. Mean age was 42 years. Placebo was associated with significant decline in LS BMD at both 6 (2.4%) and 12 (4.1%) months. Similarly, total hip BMD declined by 0.8% at 6 months and 2.6% at 12 months. In contrast, BMD remained stable in ZA patients (P < .0001 compared with placebo). Conclusion Premenopausal women receiving chemotherapy for BC sustained significant bone loss at the LS and hip, whereas BMD remained stable in women who received ZA. Administration of ZA during the first year of chemotherapy is an effective and well-tolerated strategy for preventing bone loss.

Weight change in women treated with adjuvant therapy or observed following mastectomy for node-positive breast cancer.

1990 ◽  
Vol 8 (8) ◽  
pp. 1327-1334 ◽  
Author(s):  
J K Camoriano ◽  
C L Loprinzi ◽  
J N Ingle ◽  
T M Therneau ◽  
J E Krook ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Adjuvant Chemotherapy ◽  
Weight Change ◽  
Postmenopausal Breast Cancer ◽  
Premenopausal Women ◽  
Breast Cancer Patients ◽  
Risk Of Death ◽  
Node Positive ◽  
Positive Breast Cancer

Six hundred forty-six women with node-positive breast cancer from two prospective, randomized, adjuvant breast cancer trials were evaluated for changes in weight during and after receiving 60 weeks of chemotherapy, chemohormonal therapy, or observation. The median weight change in the 545 patients remaining on protocol at 60 weeks for observed postmenopausal patients was +1.8 kg, for treated postmenopausal patients +3.6 kg, and for treated premenopausal patients +5.9 kg (P less than .001). After a median follow-up of 6.6 years, premenopausal women who gained more than the median weight at 60 weeks had a risk of relapse 1.5 times greater (covariate P = .17) and a risk of death 1.6 times greater (covariate P = .04) than premenopausal women who had gained less than the median weight. In the postmenopausal patients, the trend for inferior relapse-free and overall survival in those who gained more than the median weight at 60 weeks was not significant (P = .05). We conclude that, relative to observation, adjuvant chemotherapy is associated with greater weight gain in node-positive, postmenopausal breast cancer patients; the amount of weight gain appears greater for premenopausal than postmenopausal women, and in premenopausal women, excessive weight gain may be associated with an increase in relapse and cancer-related deaths in the selected patients who show no evidence of recurrence during 60 weeks of adjuvant chemotherapy. This last point must be interpreted with caution because of the exploratory nature of the analyses.

scholarly journals Clinical and Pathological Characteristics of Young Female Breast Cancer

2021 ◽  
Author(s):  
Dan Zheng ◽  
Ting Luo ◽  
Xiaorong Zhong ◽  
Chengshi Wang ◽  
Ping He ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Cancer Patients ◽  
Young Women ◽  
Hormone Receptor ◽  
Adjuvant Radiotherapy ◽  
Survival Outcomes ◽  
Breast Cancer Patients ◽  
Young Breast Cancer

Abstract BackgroundWith the increase in socioeconomic status and development of early screening technologies, the proportion of young breast cancer has gradually increased. However, epidemiological research on breast cancer in young women is lagging. There is a lack of diagnosis and treatment guidelines specifically for young breast cancer patients. MethodsThis is an single-center, retrospective cohort study which adopted 2,142 women ≤ 41 years who were diagnosed with stage I-III invasive breast cancer. Patients were grouped into hormone receptor-positive and -negative groups. Variance of common characteristics between the two groups were compared using Chi-square test, Fisher-exact test and Wilcoxon rank sum test. Cox proportional hazards regression was employed for survival estimation and Kaplan–Meier curves were used to graphically present the survival data. Propensity score matching was used to balanced covariates between patients who received or not received the same treatment. ResultsThe median age of the whole cohort was 37 (16-40), and 75.0% suffered from hormone receptor (HR) positive tumors. Modified radical mastectomy was the most frequent surgery (77.7%), and 78.7% women received adjuvant chemotherapy. Adjuvant radiotherapy was implemented in 39.0% of patients, and 58.3% women did not receive radiotherapy. The HR-positive status independently predicted unfavorable overall survival (OS, HR = 1.50, 95% CI 1.03-2.21, P = 0.04) and invasive disease-free survival (iDFS, HR = 1.47, 95% CI 1.05-2.05, P = 0.02). After propensity score matching (PSM), adjuvant chemotherapy (HR = 0.47, 95% CI 0.26-0.87, P = 0.02), and adjuvant radiotherapy (HR = 0.54, 95% CI 0.37-0.78, P = 0.001) improved OS significantly. Adjuvant chemotherapy predicted favorable iDFS (HR = 0.60, 95% CI 0.38-0.94, P = 0.03). Endocrine therapy improved both OS and iDFS in patients with HR-positive disease. ConclusionThe number of young women with breast cancer is gradually increasing, and these women have worse survival outcomes than their elder counterparts. HR-positive disease predicted worse long-term survival outcomes. Adjuvant chemotherapy and adjuvant radiotherapy were required for all of the young patients. Young women with HR-positive disease can benefit from endocrine therapy. No clear benefit was seen from neoadjuvant chemotherapy in young women with early-stage breast cancer.

Adjuvant chemotherapy in young breast cancer patients with endrocrine receptor (ER) disease

The Breast ◽  
2018 ◽  
Vol 41 ◽  
pp. S17
Author(s):  
Paulo Luz ◽  
David Dias ◽  
Júlio Teixeira ◽  
Beatriz Gosalbez Gosalbez ◽  
Tânia Madureira ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Young Breast Cancer
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