Time-dependent anti-Müllerian hormone dynamics during GnRHa-based endocrine therapy in young breast cancer survivors: a longitudinal real-world cohort study.
5 affiliations
- 1Department of VIP, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
- 2Department of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
- 3Department of Radiation Oncology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510100, People's Republic of China.
- 4Department of Clinical Research, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
- 5Department of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China. [email protected].
Abstract
Background
Anti-Müllerian hormone (AMH) is widely used to assess ovarian reserve in young women with breast cancer. However, its interpretation during gonadotropin-releasing hormone agonist (GnRHa)-based endocrine therapy remains challenging because pharmacologic ovarian suppression may alter AMH levels over time. We aimed to characterize longitudinal AMH dynamics according to chemotherapy exposure and subsequent GnRHa-based endocrine therapy.Methods
We conducted a retrospective longitudinal cohort study of women diagnosed with early breast cancer before age 40 at Sun Yat-sen University Cancer Center between August 2019 and December 2024. Patients were categorized into four groups according to chemotherapy exposure and GnRHa-based endocrine therapy. Longitudinal trajectories of log-transformed AMH were modeled using linear mixed-effects models with restricted cubic splines, adjusting for prespecified clinical covariates. Sensitivity analyses included baseline-AMH adjustment and exclusion of observations with extreme standardized residuals.Results
The full cohort included 685 women contributing 1758 AMH measurements. The adjusted complete-case model included 613 women contributing 1602 measurements. The group-by-time interaction was significant (likelihood ratio χ² = 249.33, df = 9, P < 0.001), demonstrating distinct AMH trajectories across treatment groups. Among women without chemotherapy, predicted AMH did not differ significantly between those with and without GnRHa-based endocrine therapy. Among chemotherapy-treated patients, the GnRHa-based endocrine therapy group was associated with lower predicted AMH at 12 and 36 months, but the differences attenuated at later follow-up. Similar trajectory patterns were observed in sensitivity analyses.Conclusions
AMH trajectories during GnRHa-based endocrine therapy are time-dependent and influenced by treatment context. AMH measurements during GnRHa exposure should be interpreted in relation to treatment timing and longitudinal changes rather than as isolated indicators of ovarian reserve.
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BibTeX
@article{jiang2026timedependent,
title = {{Time-dependent anti-Müllerian hormone dynamics during GnRHa-based endocrine therapy in young breast cancer survivors: a longitudinal real-world cohort study.}},
author = {Chang Jiang and Xiwen Bi and Xin Hua and Zhongyu Yuan and Ying Guo and Shusen Wang and Yanxia Shi and Fei Xu and Yongyi Zhong and Cong Xue},
journal = {Breast cancer research : BCR},
year = {2026},
month = aug,
doi = {10.1186/s13058-026-02359-9},
url = {https://europepmc.org/article/MED/42963797},
note = {CC BY},
}
RIS
TY - JOUR
TI - Time-dependent anti-Müllerian hormone dynamics during GnRHa-based endocrine therapy in young breast cancer survivors: a longitudinal real-world cohort study.
AU - Chang Jiang
AU - Xiwen Bi
AU - Xin Hua
AU - Zhongyu Yuan
AU - Ying Guo
AU - Shusen Wang
AU - Yanxia Shi
AU - Fei Xu
AU - Yongyi Zhong
AU - Cong Xue
PY - 2026
DA - 2026/08/04
JO - Breast cancer research : BCR
DO - 10.1186/s13058-026-02359-9
UR - https://europepmc.org/article/MED/42963797
AB - Background Anti-Müllerian hormone (AMH) is widely used to assess ovarian reserve in young women with breast cancer. However, its interpretation during gonadotropin-releasing hormone agonist (GnRHa)-based endocrine therapy remains challenging because pharmacologic ovarian suppression may alter AMH levels over time. We aimed to characterize longitudinal AMH dynamics according to chemotherapy exposure and subsequent GnRHa-based endocrine therapy.Methods We conducted a retrospective longitudinal cohort study of women diagnosed with early breast cancer before age 40 at Sun Yat-sen University Cancer Center between August 2019 and December 2024. Patients were categorized into four groups according to chemotherapy exposure and GnRHa-based endocrine therapy. Longitudinal trajectories of log-transformed AMH were modeled using linear mixed-effects models with restricted cubic splines, adjusting for prespecified clinical covariates. Sensitivity analyses included baseline-AMH adjustment and exclusion of observations with extreme standardized residuals.Results The full cohort included 685 women contributing 1758 AMH measurements. The adjusted complete-case model included 613 women contributing 1602 measurements. The group-by-time interaction was significant (likelihood ratio χ² = 249.33, df = 9, P < 0.001), demonstrating distinct AMH trajectories across treatment groups. Among women without chemotherapy, predicted AMH did not differ significantly between those with and without GnRHa-based endocrine therapy. Among chemotherapy-treated patients, the GnRHa-based endocrine therapy group was associated with lower predicted AMH at 12 and 36 months, but the differences attenuated at later follow-up. Similar trajectory patterns were observed in sensitivity analyses.Conclusions AMH trajectories during GnRHa-based endocrine therapy are time-dependent and influenced by treatment context. AMH measurements during GnRHa exposure should be interpreted in relation to treatment timing and longitudinal changes rather than as isolated indicators of ovarian reserve.
SN - 1465-5411
SN - 1465-542X
ER -