Abstract
This study aimed to evaluate and compare the effects of various endocrine therapies on lipid profiles in young patients with breast cancer. A retrospective, single-center study was performed to investigate the effects of tamoxifen (TAM), tamoxifen plus ovarian function suppression (TAM+OFS), and aromatase inhibitors plus ovarian function suppression (AI+OFS) on lipid profiles during the 60 months of endocrine therapy in hormone receptor-positive patients aged <40 with early breast cancer. The primary endpoint was the cumulative incidence of lipid events, and the secondary endpoints were the changes in lipid profiles. A total of 230 young patients were included with the mean age of 35.7 years old. The patients in TAM group had significantly lower incidence of 5-year lipid events than those in TAM+OFS group (7.4% versus 21.3%; P=0.016) and AI+OFS group (7.4% versus 21.6%; P=0.009). The incidence of fatty liver was significantly higher in TAM+OFS group than TAM group (52.5%versus 30.9%; P=0.043). Lipid events were associated with younger age (odds ratio (OR)=0.865, 95% confidence interval (CI): 0.780-0960; P=0.006), higher baseline LDL-C (OR=14.959, 95% CI: 4.379-51.105; P<0.001), and use of OFS (OR=3.557, 95% CI: 1.151-10.989; P=0.027). Therefore, application of OFS, with younger age and higher baseline LDL-C, may increase the incidence of lipid events in premenopausal breast cancer. More care should be taken for lipid profiles during the endocrine therapy for young breast cancer patients.
Highlights
Breast cancer is the most common malignant tumor in women as well as one of the three most common cancers worldwide
Another clinical trial based on Chinese postmenopausal breast cancer detects higher incidence of lipid events in the patients undergoing anastrozole and letrozole than those treated with exemestane, indicating that nonsteroidal Ais as adjuvant therapy increased the risk of lipid events [10]
The mean age ± standard deviation (SD) was 35.7 ± 4.3 years old. 81 subjects were treated with tamoxifen, 61 subjects were treated with tamoxifen plus OFS, and 88 subjects were treated with aromatase inhibitors (AIs) plus OFS
Summary
Breast cancer is the most common malignant tumor in women as well as one of the three most common cancers worldwide. Higher total cholesterol (TC) and lowdensity lipoprotein cholesterol (LDL-C) triglyceride (TG) is found in Japanese postmenopausal breast cancer treated with tamoxifen, compared to those received anastrozole and exemestane [9]. Another clinical trial based on Chinese postmenopausal breast cancer detects higher incidence of lipid events in the patients undergoing anastrozole and letrozole than those treated with exemestane, indicating that nonsteroidal Ais as adjuvant therapy increased the risk of lipid events [10]. Other studies show negative effects of endocrine treatment on lipid profiles in premenopausal patients with breast cancer [11, 12]
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