A New Model Including AMH Cut-off Levels to Predict Post-treatment Ovarian Function in Early Breast Cancer: A...

Area of Science:

• Oncology
• Reproductive Endocrinology

Background:

• Breast cancer treatments can impair fertility, necessitating careful consideration of fertility preservation.
• Identifying women unlikely to experience infertility post-treatment is crucial to avoid unnecessary procedures and hormone exposure.

Purpose of the Study:

• To define a predictive model for post-treatment ovarian reserve in breast cancer patients.
• To establish a threshold for pre-treatment anti-Mullerian hormone (AMH0) to guide fertility preservation decisions.

Main Methods:

• A multicenter prospective cohort study included women aged ≤45 with non-metastatic breast cancer.
• Anti-Mullerian hormone levels (pre-treatment AMH0 and post-treatment AMH2) and hormonal features were measured.
• Receiver operating characteristic (ROC) curve, decision tree (DT), and random forest analyses were employed to develop a predictive model.

Main Results:

• ROC analysis indicated AMH0 > 3 ng/mL as the best predictor for AMH2 ≥ 0.7 (AUC=0.69).
• A predictive model combining AMH0 > 3.3, menarche age < 14, and age < 31 achieved 93% probability in predicting AMH2 > 0.7.
• The model demonstrated high accuracy in identifying patients likely to retain ovarian reserve.

Conclusions:

• A novel model integrating AMH0, menarche age, and patient age can identify breast cancer patients who may not require fertility preservation.
• This model has the potential to reduce unnecessary fertility preservation procedures.
• Further validation through larger studies is recommended.