Undetectable antimüllerian hormone levels and recovery of chemotherapy-induced ovarian failure in women with breast cancer on an oral aromatase inhibitor
| Autor: | Inge Geerts, Hans Wildiers, Robert Paridaens, Patrick Neven, Johan Vandenberghe, Jaak Billen, Anne-Sophie Dieudonné |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Anti-Mullerian Hormone Oncology endocrine system medicine.medical_specialty Antineoplastic Agents Hormonal endocrine system diseases medicine.drug_class Population Menopause Premature Administration Oral Breast Neoplasms Ovary Primary Ovarian Insufficiency Endometrium Breast cancer Pregnancy Internal medicine medicine Humans skin and connective tissue diseases education Amenorrhea Monitoring Physiologic education.field_of_study Aromatase inhibitor biology Aromatase Inhibitors business.industry Obstetrics and Gynecology Anti-Müllerian hormone Recovery of Function Middle Aged medicine.disease Menopause Tamoxifen Fertility medicine.anatomical_structure biology.protein Female medicine.symptom business Biomarkers hormones hormone substitutes and hormone antagonists medicine.drug |
| Zdroj: | Menopause. 18:821-824 |
| ISSN: | 1072-3714 |
| DOI: | 10.1097/gme.0b013e318204af88 |
| Popis: | Objective Knowledge of the menopause status of a woman with breast cancer is important for good clinical practice. Long-lasting amenorrhea is frequent in this population, often for reasons other than definitive menopause. Antiestrogens like tamoxifen or oral aromatase inhibitors (AIs) may reactivate the ovary causing vaginal bleeding, menstruation, pregnancy, and unopposed endometrial stimulation. In contrast to tamoxifen, AIs are not active against breast cancer in the presence of functional ovaries. Antimullerian hormone (AMH) is a potential marker of residual ovarian function that can predict not only the onset of menopause but also chemotherapy-induced amenorrhea (CIA) and fertility. We assess the value of AMH in women who recovered from CIA on an AI. Methods This is a series of six women with clinical and biochemical evidence of ovarian recovery during AI treatment. All six were premenopausal at breast cancer diagnosis and developed CIA. AMH, follicle-stimulating hormone, and estradiol levels were measured when patients developed clinical signs of ovarian recovery and/or when a gynecological procedure showed evidence of this. Results In all six AI-treated women, AMH levels were undetectable despite clinical, biochemical, or pathological evidence of ovarian reactivation after a long period of amenorrhea and sensitive biochemical markers indicating definitive menopause status. Conclusions Repeated biochemical monitoring of ovarian function remains important in women with breast cancer undergoing AI treatment because ovarian function can recover, AIs are not active with functional ovaries, and amenorrhea does not, by itself, confirm definitive menopause. Undetectable AMH levels do not exclude residual ovarian function in women with breast cancer on an AI. |
| Databáze: | OpenAIRE |
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