Development of cardiometabolic risk factors following endocrine therapy in women with breast cancer
- 16.06.2023
- Epidemiology
Erschienen in:
- Verfasst von
- Eileen Rillamas-Sun
- Marilyn L. Kwan
- Carlos Iribarren
- Richard Cheng
- Romain Neugebauer
- Jamal S. Rana
- Mai Nguyen-Huynh
- Zaixing Shi
- Cecile A. Laurent
- Valerie S. Lee
- Janise M. Roh
- Yuhan Huang
- Hanjie Shen
- Dawn L. Hershman
- Lawrence H. Kushi
- Heather Greenlee
- Erschienen in
- Breast Cancer Research and Treatment | Ausgabe 1/2023
Abstract
Purpose
Studies comparing the effect of aromatase inhibitor (AI) and tamoxifen use on cardiovascular disease (CVD) risk factors in hormone receptor-positive breast cancer (BC) survivors report conflicting results. We examined associations of endocrine therapy use with incident diabetes, dyslipidemia, and hypertension.
Methods
The Pathways Heart Study examines cancer treatment exposures with CVD-related outcomes in Kaiser Permanente Northern California members with BC. Electronic health records provided sociodemographic and health characteristics, BC treatment, and CVD risk factor data. Hazard ratios (HR) and 95% confidence intervals (CI) of incident diabetes, dyslipidemia, and hypertension in hormone receptor-positive BC survivors using AIs or tamoxifen compared with survivors not using endocrine therapy were estimated using Cox proportional hazards regression models adjusted for known confounders.
Results
In 8985 BC survivors, mean baseline age and follow-up time was 63.3 and 7.8 years, respectively; 83.6% were postmenopausal. By treatment, 77.0% used AIs, 19.6% used tamoxifen, and 16.0% used neither. Postmenopausal women who used tamoxifen had an increased rate (HR 1.43, 95% CI 1.06–1.92) of developing hypertension relative to those who did not use endocrine therapy. Tamoxifen use was not associated with incident diabetes, dyslipidemia, or hypertension in premenopausal BC survivors. Postmenopausal AI users had higher hazard rates of developing diabetes (HR 1.37, 95% CI 1.05–1.80), dyslipidemia (HR 1.58, 95% CI 1.29–1.92), and hypertension (HR 1.50, 95% CI 1.24–1.82) compared with non-endocrine therapy users.
Conclusion
Hormone receptor-positive BC survivors treated with AIs may have higher rates of developing diabetes, dyslipidemia, and hypertension over an average 7.8 years post-diagnosis.
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- Titel
- Development of cardiometabolic risk factors following endocrine therapy in women with breast cancer
- Verfasst von
-
Eileen Rillamas-Sun
Marilyn L. Kwan
Carlos Iribarren
Richard Cheng
Romain Neugebauer
Jamal S. Rana
Mai Nguyen-Huynh
Zaixing Shi
Cecile A. Laurent
Valerie S. Lee
Janise M. Roh
Yuhan Huang
Hanjie Shen
Dawn L. Hershman
Lawrence H. Kushi
Heather Greenlee
- Publikationsdatum
- 16.06.2023
- Verlag
- Springer US
- Erschienen in
-
Breast Cancer Research and Treatment / Ausgabe 1/2023
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217 - DOI
- https://doi.org/10.1007/s10549-023-06997-x
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