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Jalaeefar, A., Moini, A., Eslami, B., Alipour, S., Shirkhoda, M., Aryan, A., Mahmoodzadeh, H., & Omranipour, R. (2021). Abnormal anti-Müllerian hormone level may be a trigger for breast cancer in young women: A case-control study. International Journal of Reproductive BioMedicine (IJRM), 19(2), 181–190. https://doi.org/10.18502/ijrm.v19i2.8476
https://doi.org/10.18502/ijrm.v19i2.8476
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authors
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Amirmohsen Jalaeefar
Amirmohsen Jalaeefar
Department of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ashraf Moini
Ashraf Moini
Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran
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Bita Eslami
Bita Eslami
Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran
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Sadaf Alipour
Sadaf Alipour
Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran
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Mohammad Shirkhoda
Mohammad Shirkhoda
Department of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
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Arvin Aryan
Arvin Aryan
Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Habibollah Mahmoodzadeh
Habibollah Mahmoodzadeh
Department of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ramesh Omranipour
Ramesh Omranipour
Department of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
Published Date
- Feb 21, 2021
Abnormal anti-Müllerian hormone level may be a trigger for breast cancer in young women: A case-control study
Abstract
Background: Anti-Müllerian hormone (AMH) is a known sensitive biomarker for fertility and ovarian reserve. The results of in vivo and human studies showed inconsistency with respect to the relation between AMH and breast cancer.
Objective: To compare the AMH level of young Iranian women with early breast cancer who have not received any treatment compared to that of healthy women.
Materials and Methods: In this case-control study, 58 breast cancer cases were recruited from the breast oncology clinic of two university hospitals. They were diagnosed with an in situ or invasive breast cancer before any anticancer treatment between August 2018 and April 2019. Healthy controls (n = 58) were selected from women referred to a gynecologic outpatient clinic without any symptoms of cancer or infertility. AMH was measured by the AMH enzyme-linked immunosorbent assay kits in one laboratory.
Results: Final analysis showed that the AMH means of case and control were not statistically significant (3.36 ± 2.95 vs 3.13 ± 1.79). However, the lower and higher AMH level categories are more prevalent in breast cancer compared to the control. Pearson’s correlation test showed that the AMH level was negatively correlated with age (r = -0.44, p< 0.001). The results of logistic regression analysis considering confounding factors showed the positive association between breast cancer and lower (Odds Ratio [OR] = 5.98, p = 0.02) and higher quartile of AMH level (OR = 4.95, p = 0.01).
Conclusion: Our results suggest that abnormal AMH level is more frequent in young breast cancer patients. Further investigation considering AMH determinants is required.
Key words: Anti-Müllerian hormone, Breast cancer, Biomarkers, Ovarian reserve.
References
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[6] La Marca A, Grisendi V, Griesinger G. How much does AMH really vary in normal women? Int J Endocrinol 2013; 2013: 959487.
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[14] Dorgan JF, Stanczyk FZ, Egleston BL, Kahle LL, Shaw CM, Spittle CS, et al. Prospective case-control study of serum Müllerian Inhibiting Substance and breast cancer risk. J Natl Cancer Inst 2009; 101: 1501–1509.
[15] Nichols HB, Baird DD, Stanczyk FZ, Steiner AZ, Troester MA, Whitworth KW, et al. Anti-Müllerian hormone concentrations in premenopausal women and breast cancer risk. Cancer Prev Res 2015; 8: 528–534.
[16] Eliassen AH, Zeleniuch-Jacquotte A, Rosner B, Hankinson SE. Plasma anti-Müllerian hormone concentrations and risk of breast cancer among premenopausal women in the Nurses’ Health Studies. Cancer Epidemiol Biomarkers Prev 2016; 25: 854–860.
[17] Ge W, Clendenen TV, Afanasyeva Y, Koenig KL, Agnoli C, Brinton LA, et al. Circulating anti−Müllerian hormone and breast cancer risk: A study in ten prospective cohorts. Int J Cancer 2018; 142: 2215–2226.
[18] Dewailly D, Robin G, Peigne M, Decanter C, Pigny P, Catteau-Jonard S. Interactions between androgens, FSH, anti-Müllerian hormone and estradiol during folliculogenesis in the human normal and polycystic ovary. Hum Reprod Update 2016; 22: 709–724.
[19] World Health Organization. The Asia-Pacific perspective: Redefining obesity and its treatment. 2000. Available at: https://apps.who.int/iris/bitstream/handle/10665/206936/ 0957708211_eng.pdf.
[20] Ebbel E, Katz A, Kao CN, Cedars M. Reproductive aged women with cancer have a lower antral follicle count than expected. Fertil Steril 2011; 96: 199–200.
[21] Kerlikowske K, Ma L, Scott CG, Mahmoudzadeh AP, Jensen MR, Sprague BL, et al. Combining quantitative and qualitative breast density measures to assess breast cancer risk. Breast Cancer Res 2017; 19: 97.
[22] Bertrand KA, Baer HJ, Orav EJ, Klifa C, Kumar A, Hylton NM, et al. Early life body fatness, serum anti-müllerian hormone, and breast density in young adult women. Cancer Epidemiol Biomarkers Prev 2016; 25: 1151–1157.
[23] Rustamov O, Smith A, Roberts SA, Yates AP, Fitzgerald C, Krishnan M, et al. The measurement of anti-Mullerian hormone: A critical appraisal. J Clin Endocrinol Metab 2014; 99: 723–732.
[24] Wiweko B, Indra I, Susanto C, Natadisastra M, Hestiantoro A. The correlation between serum AMH and HOMA-IR among PCOS phenotypes. BMC Res Notes 2018; 11: 114.
[25] Blumenfeld Z. Anti-Mullerian hormone and breast cancer risk-is the correlation possibly associated with the PCOS? Int J Cancer 2019; 144: 210–211.
[26] Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: A systematic review and meta-analysis. Hum Reprod Update 2014; 20: 748–758.
[27] Harris HR, Terry KL. Polycystic ovary syndrome and risk of endometrial, ovarian, and breast cancer: A systematic review. Fertil Res Pract 2016; 2: 14.
[28] Son K-A, Lee D-Y, Choi D. Association of BRCA mutations and anti-Müllerian hormone level in young breast cancer patients. Front Endocrinol 2019; 10: 235.
[29] Wallace AM, Faye SA, Fleming R, Nelson SM. A multicentre evaluation of the new Beckman Coulter anti-Müllerian hormone immunoassay (AMH Gen II). Ann Clin Biochem 2011; 48: 370–373.
[2] Desreux JAC. Breast cancer screening in young women. Eur J Obstet Gynecol Reprod Biol 2018; 230: 208–211.
[3] Merlo DF, Ceppi M, Filiberti R, Bocchini V, Znaor A, Gamulin M, et al. Breast cancer incidence trends in European women aged 20-39 years at diagnosis. Breast Cancer Res Treat 2012; 134: 363–370.
[4] YektaKooshali MH, Esmaeilpour-Bandboni M, Sharami SH, Alipour Z. Survival rate and average age of the patients with breast cancer in Iran: Systematic review and metaanalysis. J Babol Univ Med Sci 2016; 18: 29–40.
[5] Shirkhande L, Shirkhande B, Shirkhande A. AMH and its clinical implications. J Obstet Gynecol India 2020; 70: 337–341.
[6] La Marca A, Grisendi V, Griesinger G. How much does AMH really vary in normal women? Int J Endocrinol 2013; 2013: 959487.
[7] Kim JH, MacLaughlin DT, Donahoe PK. Müllerian inhibiting substance/anti-Müllerian hormone: A novel treatment for gynecologic tumors. Obstet Gynecol Sci 2014; 57: 343– 357.
[8] Gupta V, Carey JL, Kawakubo H, Muzikansky A, Green JE, Donahoe PK, et al. Mullerian inhibiting substance suppresses tumor growth in the C3(1)T antigen transgenic mouse mammary carcinoma model. Proc Natl Acad Sci USA 2005; 102: 3219–3224.
[9] Segev DL, Ha TU, Tran TT, Kenneally M, Harkin P, Jung M, et al. Müllerian inhibiting substance inhibits breast cancer cell growth through an NFκB-mediated pathway. J Biolo Chem 2000; 275: 28371–28379.
[10] Hoshiya Y, Gupta V, Segev DL, Hoshiya M, Carey JL, Sasur LM, et al. Mullerian inhibiting substance induces NFkB signaling in breast and prostate cancer cells. Mol Cell Endocrinol 2003; 211: 43–49.
[11] MacLaughlin DT, Donahoe PK. Müllerian inhibiting substance/anti-Müllerian hormone: A potential therapeutic agent for human ovarian and other cancers. Future Oncol 2010; 6: 391–405.
[12] McCoy AC, Kliethermes B, Zhang K, Qin W, Sticca R, Bouton M, et al. Serum Müllerian inhibiting substance levels are lower in premenopausal women with breast precancer and cancer. BMC Res Notes 2011; 4: 152.
[13] Su HI, Flatt SW, Natarajan L, DeMichele A, Steiner AZ. Impact of breast cancer on anti-mullerian hormone levels in young women. Breast Cancer Res Treat 2013; 137: 571– 577.
[14] Dorgan JF, Stanczyk FZ, Egleston BL, Kahle LL, Shaw CM, Spittle CS, et al. Prospective case-control study of serum Müllerian Inhibiting Substance and breast cancer risk. J Natl Cancer Inst 2009; 101: 1501–1509.
[15] Nichols HB, Baird DD, Stanczyk FZ, Steiner AZ, Troester MA, Whitworth KW, et al. Anti-Müllerian hormone concentrations in premenopausal women and breast cancer risk. Cancer Prev Res 2015; 8: 528–534.
[16] Eliassen AH, Zeleniuch-Jacquotte A, Rosner B, Hankinson SE. Plasma anti-Müllerian hormone concentrations and risk of breast cancer among premenopausal women in the Nurses’ Health Studies. Cancer Epidemiol Biomarkers Prev 2016; 25: 854–860.
[17] Ge W, Clendenen TV, Afanasyeva Y, Koenig KL, Agnoli C, Brinton LA, et al. Circulating anti−Müllerian hormone and breast cancer risk: A study in ten prospective cohorts. Int J Cancer 2018; 142: 2215–2226.
[18] Dewailly D, Robin G, Peigne M, Decanter C, Pigny P, Catteau-Jonard S. Interactions between androgens, FSH, anti-Müllerian hormone and estradiol during folliculogenesis in the human normal and polycystic ovary. Hum Reprod Update 2016; 22: 709–724.
[19] World Health Organization. The Asia-Pacific perspective: Redefining obesity and its treatment. 2000. Available at: https://apps.who.int/iris/bitstream/handle/10665/206936/ 0957708211_eng.pdf.
[20] Ebbel E, Katz A, Kao CN, Cedars M. Reproductive aged women with cancer have a lower antral follicle count than expected. Fertil Steril 2011; 96: 199–200.
[21] Kerlikowske K, Ma L, Scott CG, Mahmoudzadeh AP, Jensen MR, Sprague BL, et al. Combining quantitative and qualitative breast density measures to assess breast cancer risk. Breast Cancer Res 2017; 19: 97.
[22] Bertrand KA, Baer HJ, Orav EJ, Klifa C, Kumar A, Hylton NM, et al. Early life body fatness, serum anti-müllerian hormone, and breast density in young adult women. Cancer Epidemiol Biomarkers Prev 2016; 25: 1151–1157.
[23] Rustamov O, Smith A, Roberts SA, Yates AP, Fitzgerald C, Krishnan M, et al. The measurement of anti-Mullerian hormone: A critical appraisal. J Clin Endocrinol Metab 2014; 99: 723–732.
[24] Wiweko B, Indra I, Susanto C, Natadisastra M, Hestiantoro A. The correlation between serum AMH and HOMA-IR among PCOS phenotypes. BMC Res Notes 2018; 11: 114.
[25] Blumenfeld Z. Anti-Mullerian hormone and breast cancer risk-is the correlation possibly associated with the PCOS? Int J Cancer 2019; 144: 210–211.
[26] Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: A systematic review and meta-analysis. Hum Reprod Update 2014; 20: 748–758.
[27] Harris HR, Terry KL. Polycystic ovary syndrome and risk of endometrial, ovarian, and breast cancer: A systematic review. Fertil Res Pract 2016; 2: 14.
[28] Son K-A, Lee D-Y, Choi D. Association of BRCA mutations and anti-Müllerian hormone level in young breast cancer patients. Front Endocrinol 2019; 10: 235.
[29] Wallace AM, Faye SA, Fleming R, Nelson SM. A multicentre evaluation of the new Beckman Coulter anti-Müllerian hormone immunoassay (AMH Gen II). Ann Clin Biochem 2011; 48: 370–373.