Impact of adjuvant chemotherapy or tamoxifen-alone on the ovarian reserve of young women with breast cancer

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dc.authorscopusid31767766600en_US
dc.contributor.authorGoldfarb, Shari B.
dc.contributor.authorTuran, Volkan
dc.contributor.authorBedoschi, Giuliano
dc.contributor.authorTaylan, Enes
dc.contributor.authorAbdo, Nadia
dc.contributor.authorCigler, Tessa
dc.contributor.authorBang, Heejung
dc.contributor.authorPatil, Sujita
dc.contributor.authorDickler, Maura N.
dc.contributor.authorOktay, Kutluk H.
dc.date.accessioned2021-12-21T13:29:21Z
dc.date.available2021-12-21T13:29:21Z
dc.date.issued2021en_US
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve Doğum Ana Bilim Dalıen_US
dc.description.abstractPurpose To determine the longitudinal impact of adjuvant chemotherapy and tamoxifen-only treatments on the reproductive potential of women with breast cancer by using a sensitive ovarian reserve marker anti-Mullerian hormone (AMH) as a surrogate. Methods One-hundred-and-forty-two women with a primary diagnosis of breast cancer were prospectively followed with serum AMH assessments before the initiation, and 12, 18 and 24 months after the completion of adjuvant chemotherapy or the start of tamoxifen-only treatment. The chemotherapy regimens were classified into Anthracycline-Cyclophosphamide-based (AC-based) and Cyclophosphamide-Methotrexate + 5-Fluorouracil (CMF). Longitudinal data were analyzed by mixed effects model for treatment effects over time, adjusting for baseline age and BMI. Results Both chemotherapy regimens resulted in significant decline in ovarian reserve compared to the tamoxifen-only treatment (p < 0.0001 either regimen vs. tamoxifen for overall trend). AMH levels sharply declined at 12 months but did not show a significant recovery from 12 to 18 and 18 to 24 months after the completion of AC-based or CMF regimens. The degree of decline did not differ between the two chemotherapy groups (p = 0.53). In contrast, tamoxifen-only treatment did not significantly alter the age-adjusted serum AMH levels over the 24-month follow up. Likewise, the use of adjuvant tamoxifen following AC-based regimens did not affect AMH recovery. Conclusions Both AC-based regimens and CMF significantly compromise ovarian reserve, without a recovery beyond 12 months post-chemotherapy. In contrast, tamoxifen-only treatment does not seem to alter ovarian reserve. These data indicate that the commonly used chemotherapy regimens but not the hormonal therapy compromise future reproductive potential.en_US
dc.identifier.citationGoldfarb, S. B., Turan, V., Bedoschi, G., Taylan, E., Abdo, N., Cigler, T., Bang, H., Patil, S., Dickler, M. N., & Oktay, K. H. (2021). Impact of adjuvant chemotherapy or tamoxifen-alone on the ovarian reserve of young women with breast cancer. Breast Cancer Research and Treatment, 185(1), pp. 165-173. https://doi.org/10.1007/s10549-020-05933-7en_US
dc.identifier.doi10.1007/s10549-020-05933-7en_US
dc.identifier.endpage173en_US
dc.identifier.issue1en_US
dc.identifier.pmidPMID: 32930927en_US
dc.identifier.scopus2-s2.0-85091042082en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage165en_US
dc.identifier.urihttps://doi.org/10.1007/s10549-020-05933-7
dc.identifier.urihttps://hdl.handle.net/20.500.13055/102
dc.identifier.volume185en_US
dc.identifier.wosWOS:000569566700004en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expandeden_US
dc.institutionauthorTuran, Volkan
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofBreast Cancer Research and Treatmenten_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectDrug Therapyen_US
dc.subjectBreast Neoplasmsen_US
dc.subjectAnti-Mullerian Hormoneen_US
dc.subjectFertility Preservationen_US
dc.subjectOvarian Reserveen_US
dc.titleImpact of adjuvant chemotherapy or tamoxifen-alone on the ovarian reserve of young women with breast canceren_US
dc.typeArticleen_US
dspace.entity.typePublication

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