The Examination of Ovarian Reserve in Premenopausal Patients with Hormone Receptor Positive Breast Cancer

Hyun-Ah Kim; Joohyun Woo; Hyang Suk Choi; Seok Joon Lee; Jihye Choi; Chan Sub Park; Min-Ki Seong; Woo Chul Noh

doi:10.12771/emj.2017.40.3.104

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Kim, Woo, Choi, Lee, Choi, Park, Seong, and Noh: The Examination of Ovarian Reserve in Premenopausal Patients with Hormone Receptor Positive Breast Cancer

Review Article

The Ewha Medical Journal 2017; 40(3): 104-107.

Published online: 28 July 2017

DOI: https://doi.org/10.12771/emj.2017.40.3.104

The Examination of Ovarian Reserve in Premenopausal Patients with Hormone Receptor Positive Breast Cancer

Hyun-Ah Kim, Joohyun Woo¹, Hyang Suk Choi, Seok Joon Lee, Jihye Choi, Chan Sub Park, Min-Ki Seong, Woo Chul Noh

Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Science, Seoul, Korea.

¹Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.

Corresponding author: Hyun-Ah Kim. Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Science, 75 Nowon-ro, Nowon-gu, Seoul 01812, Korea. Tel: 82-2-970-1280, Fax: 82-2-970-2419, hyunah@kcch.re.kr

Received 17 May 2017 Revised 22 May 2017 Accepted 23 May 2017

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The evaluation of menopausal status is an important subject in the field of treatment of hormone receptor positive breast cancer. According to the menopausal status, endocrine therapy should be categorized by individual patient. However, the gonadal injury caused by various therapeutic drugs and its recovery would confuse the interpretation of clinical and biological markers for ovarian reserve. There are some methods to examine the functional ovarian reserve indirectly. Ultrasonography for counting follicles is a relatively reliable procedure, although it is not feasible because of time-labor consumption and high cost. Biological marker from blood samples such as serum follicle stimulating hormone (FSH), serum estradiol (E2), serum inhibin, or anti-Müllerian hormone (AMH) would be a better choice. The examination of serum FSH and E2 is already recommended as biomarkers for measuring functional ovarian reserve in many guidelines. However, there are limitation of serum FSH and E2 in patients with chemotherapy-induced amenorrhea and treated by tamoxifen. AMH is promising biomarker in the field of infertility treatment even in the patients treated by chemotherapy. It might be a possible biomarker to determine the menopausal status for decision-making whether aromatase inhibitor could be applicable or not in hormone positive breast cancer patients with chemotherapy induced amenorrhea or treated by tamoxifen.

Keywords: Breast neoplasms, Anti-Mullerian hormone, Premenopause, Receptors, Estrogen

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