A prospective longitudinal analysis of the predictors of amenorrhea after breast cancer chemotherapy: Impact of BRCA pathogenic variants

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dc.authorscopusid31767766600en_US
dc.authorwosidCDM-6595-2022en_US
dc.contributor.authorOktay, Kutluk H.
dc.contributor.authorTuran, Volkan
dc.contributor.authorBedoschi, Giuliano
dc.contributor.authorAbdo, Nadia
dc.contributor.authorBang, Heejung
dc.contributor.authorGoldfarb, Shari
dc.date.accessioned2023-09-18T06:55:59Z
dc.date.available2023-09-18T06:55:59Z
dc.date.issued2023en_US
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve Doğum Ana Bilim Dalıen_US
dc.description.abstractBackground: Better tools for post-chemotherapy amenorrhea risk assessment are needed for fertility preservation decision-making. Our aim was to determine the predictors of amenorrhea risk at 12 and 18 months post-chemotherapy in women with breast cancer. Methods: 142 women with breast cancer were longitudinally followed for their menstrual changes at 6, 12, and 18 months after the completion of adjuvant chemotherapy with an Anthracycline-Cyclophosphamide-based (AC-based) or Cyclophosphamide-Methotrexate +5-Fluorouracil regimen. Pre- and/or post-chemo AMH levels, age, BMI, tamoxifen use, regimen type, and germline BRCA pathogenic variant (gBRCApv) status were evaluated for the prediction of amenorrhea at 6-18 months. Results: In multivariable-adjusted logistic regression, age (p = 0.03) and AMH (p = 0.03) at 12 months, and gBRCApv status (p = 0.03) at 18 months were significant predictors of amenorrhea (areas under the ROC curve of 0.77 and 0.76, for 12 and 18 months, respectively) among 102 evaluable subjects. An undetectable AMH immediately post-chemotherapy was predictive of amenorrhea with <18 month follow-up. In longitudinal analysis estimating time trends, baseline AMH and gBRCApv status was associated with the risk of amenorrhea over 6-18 months; the AMH >2.0 ng/mL group showed attenuated time-trend risk of amenorrhea versus AMH ≤2.0 group (ratio of ORs = 0.91, 95% CI = 0.86-0.97, p = 0.002), while the gBRCApv + showed a steeper time trend, versus the controls (ratio of ORs = 1.12, 95% CI = 1.04-1.20, p = 0.003). Conclusions: In addition to the pre- and post-treatment AMH levels, gBRCApv status is a novel potential predictor of amenorrhea at 12 and 18 months after chemotherapy. The higher likelihood of amenorrhea in women gBRCApv suggests that they are more prone to losing their fertility post-chemotherapy.en_US
dc.description.sponsorshipThis study was supported by RO1 HD053112 from the Eu-nice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and National Cancer Institute.en_US
dc.identifier.citationOktay, K. H., Turan, V., Bedoschi, G., Abdo, N., Bang, H., & Goldfarb, S. (2023). A prospective longitudinal analysis of the predictors of amenorrhea after breast cancer chemotherapy: Impact of BRCA pathogenic variants. Cancer Medicine, 12(18), pp. 19225-19233. https://doi.org/10.1002/cam4.6527en_US
dc.identifier.doi10.1002/cam4.6527en_US
dc.identifier.endpage19233en_US
dc.identifier.issn2045-7634
dc.identifier.issue18en_US
dc.identifier.pmidPMID: 37698031en_US
dc.identifier.scopus2-s2.0-85170667893en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage19225en_US
dc.identifier.urihttps://doi.org/10.1002/cam4.6527
dc.identifier.urihttps://hdl.handle.net/20.500.13055/541
dc.identifier.volume12en_US
dc.identifier.wosWOS:001067444800001en_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.publisherWileyen_US
dc.relation.ispartofCancer Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectBRCAen_US
dc.subjectAmenorrheaen_US
dc.subjectAnti-Mullerian Hormoneen_US
dc.subjectBreast Canceren_US
dc.subjectChemotherapyen_US
dc.subjectFertility Preservationen_US
dc.titleA prospective longitudinal analysis of the predictors of amenorrhea after breast cancer chemotherapy: Impact of BRCA pathogenic variantsen_US
dc.typeArticleen_US
dspace.entity.typePublication

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