Tamoxifen has been used for a long time as an adjuvant hormonal treatment in breast cancer patients. We studied 62 newly diagnosed postmenopausal women, aged 50-79 years, with node-positive breast cancer and receiving adjuvant tamoxifen (20 mg per day). Total serum cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, apo AI, apo AII, apo B and Lp(a) were determined before the surgery and 3, 6, 9, 12 and 24 months after starting tamoxifen treatment. Tamoxifen significantly reduced total serum cholesterol (6.13 ± 1.20 mmol/L vs 5.21 ± 1.05 mmol/L) (P <0.01), LDL-cholesterol (3.72 ± 0.70 mmol/L vs 2.93 ± 0.51) (P <0.01) and Lp(a) (0.11 ± 0.07 g/L vs 0.02 ± 0.01 g/L) (P <0.01). There were no changes in triglycerides or HDL-cholesterol serum levels during tamoxifen treatment. The results indicate that an additional beneficial effect of adjuvant tamoxifen therapy may be that it decreases cardiovascular risk in such patients.
JordanV.C.: Studies on the estrogen receptor in breast cancer - 20 years as a target for the treatment and prevention of cancer.Breast Cancer Res. Treat., 36: 267–285, 1995.
2.
Early Breast Cancer Trialists Collaborative Group: Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy. 133 randomised trials involving 31,000 recurrences and 24,000 deaths among 75,000 women.Lancet, 339: 71–85, 1992.
3.
PrenticeR.L.: Tamoxifen as a potential preventive agent in healthy postmenopausal women.J. Natl. Cancer Inst., 82: 1310–1311, 1990.
4.
BruningP.F.BonfrerJ.M.G.HartA.A.M.De Jong-BakkerM.LindersD.Van LoonJ.NooyenW.J.: Tamoxifen, serum lipoproteins and cardiovascular risk.Br. J. Cancer, 58: 497–499, 1988.
5.
LoveR.R.WiebeD.A.FeyziJ.M.NewcombP.A.ChapellR.J.: Effects of tamoxifen on cardiovascular risk factors in postmenopausal women after 5 years of treatment.J. Natl. Canc. Inst., 86: 1534–1539, 1994.
6.
AlaupovicP.: Determination of plasma apoprotein profiles. In: SchettlerG.GottoA.M. (Eds.), pp. 516–521, Atherosclerosis.Springer-Verlag, Heidelberg, Berlin, New York, 1982.
7.
BursteinM.ScholniczH.R.MartinR.: Rapid method for the isolation of lipoproteins from human serum by precipitation with polyanions.J. Lipid Res., 11: 583–587, 1990.
8.
GidezZ.I.MillerG.J.BursteinM.SeagiesF.EderH.A.: Separation and quantitation of subclasses of human plasma high density lipoproteins by a simple precipitation procedure.J. Lipid Res., 23: 1206–1223, 1982.
9.
FriedewaldW.T.LevyR.I.FredricksonD.S.: Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.Clin. Chem., 18: 499–502, 1972.
10.
UtermannG.WeberW.: Protein composition of Lp(a) lipoprotein from human plasma.FEBS, 154: 357–361, 1983.
11.
CuzickJ.AllenD.BaumM.BarrettJ.ClarkG.KakkarV.MelissariE.MonizC.MooreJ.ParsonsV.PembertonK.PittP.RichmondW.HoughtonJ.RileyD.: Long-term effects of tamoxifen.Eur. J. Cancer, 29A: 15–21, 1993.
12.
CatherinoW.H.JordanV.C.: A risk-benefit assessment of tamoxifen therapy.Drug Safety, 8: 381–397, 1993.
13.
Early Breast Cancer Trials’ Collaboration Group:The effects of adjuvant tamoxifen and of cytotoxic therapy on mortality in early breast cancer: an overview of 61 randomized trials among 28,896 women.N. Engl. J. Med., 319: 1681–1692, 1988.
14.
GraingerD.J.MetcalfeJ.C.: Tamoxifen: Teaching an old drug new tricks?Nat. Med., 2: 381–385, 1996.
15.
CyprianiB.TabacikC.DescompsB.: Effect of estradiol and antiestrogens on cholesterol biosynthesis in hormone-dependent and independent breast cancer cell lines.Biochim. Bio-phys. Acta., 972: 167–178, 1988.
16.
JordanV.C.PhelpsE.LindgrenJ.U.: Effect of antiestrogens on bone in castrated and intact female rats.Br. J. Cancer Res. Treat., 10: 31–35, 1987.
17.
MorrowM.JordanV.C.: Risk factors and the prevention of breast cancer with tamoxifen.Cancer Surv., 18: 211–229, 1993.
18.
FentimanI.S.SaadZ.CaleffiM.ChaudaryM.A.Fogel-manI.: Tamoxifen protects against steroid-induced bone loss.Eur. J. Cancer, 28: 684–685, 1992.
19.
SchapiraD.V.KumarN.B.LymanG.H.: Serum cholesterol reduction with tamoxifen.Breast Cancer Res. Treat., 17: 3–7, 1990.
20.
ThangarajuM.KumarK.GandhirajanR.SachdanandamP.: Effect of tamoxifen on plasma lipids and lipoproteins in postmenopausal women with breast cancer.Cancer, 73: 659–663, 1994.
21.
RossnerS.WallgrenA.: Serum lipoproteins and proteins after breast cancer surgery and effects of tamoxifen.Atherosclerosis, 52: 339–346, 1984.
22.
LoveR.R.NewcombP.A.WiebeD.A.SurawiczT.S.JordanV.C.CarboneP.P.DeMetsD.L.: Effects of tamoxifen therapy on lipid and lipoprotein levels in postmenopausal patients with node-negative breast cancer.J. Natl. Cancer Inst., 82: 1327–1332, 1990.
23.
EnganT.KraneJ.JohannessenD.C.KvinnslandS.: Plasma changes in breast cancer patients during endocrine therapy - lipid measurements and nuclear magnetic resonance (NMR) spectroscopy.Breast Cancer Res. Treat., 36: 287–297, 1995.
24.
LaneD.M.BoatmanK.K.McConathyW.J.: Serum lipids and apolipoproteins in women with breast masses.Breast Cancer Res. Treat., 34: 161–169, 1995.
25.
McDonaldC.C.StewartH.J.: Fatal myocardial infarction in the Scottish adjuvant tamoxifen trial.BMJ, 303: 435–437, 1991.
26.
BagdadeJ.D.WolterJ.SubbaibahP.V.RyanW.: Effects of tamoxifen on plasma lipids and lipoprotein composition.J. Clin. Endocrinol. Metab., 70: 1132–1135, 1990.
27.
MoralesM.SantanaN.SoriaA.MosqueraA.OrdovasJ.NovoaJ.BetancorP.ValeronP.F.Diaz-ChicoB.ChirinoR.: Effects of tamoxifen on serum lipid and lipoprotein levels in postmenopausal patients with breast cancer.Breast Cancer Res. Treat., 40: 265–270, 1996.
28.
ShewmonD.A.StockJ.L.AbusamraL.C.KristanM.A.BakerS.HeiniluomaK.M.: Tamoxifen decreases lipoprotein(a) in patients with breast cancer.Metabolism, 43: 531–532, 1994.
29.
ReinerZ.VrbanecD.PezerovicD.: Antiestrogen tamoxifen reduces lipoprotein(a). Abstracts. The Second International Conference on Lipoprotein(a). New Orleans, November 12-14, 1992, p. 124.
30.
ShewmanD.A.StockJ.L.RosenC.J.HeiniluomaK.M.HayneM.M.MorrisonA.DoyleE.M.UhenaT.WealeV.BakerS.: Tamoxifen and estrogen lower circulating lipoprotein(a) concentration in healthy postmenopausal women.Ath-eroscl. Thromb., 14: 1586–1593, 1994.
31.
KostnerG.M.AvogaroP.CazzolatoG.MarthE.Bittolo-BonG.QuiciG.B.: Lipoprotein(a) and the risk for myocardial infarction.Atherosclerosis, 38: 51–58, 1981.
