Tamoxifen Treatment and the Reduced Risk of Hyperlipidemia in Asian Patients With Breast Cancer: A Population-Based Cohort Study

• Published in: Clinical breast cancer Vol. 15; no. 4; pp. 294 - 300
• Main Authors: Lim, Yun-Ping, Lin, Cheng-Li, Lin, Yen-Ning, Ma, Wei-Chih, Hung, Dong-Zong, Kao, Chia-Hung
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2015
• Subjects: Adolescent; Adult; Aged; Asian Continental Ancestry Group; Breast cancer; Breast Neoplasms - drug therapy; Cohort Studies; Female; Hematology, Oncology and Palliative Medicine; Humans; Hyperlipidemia; Hyperlipidemias - epidemiology; Incidence; Middle Aged; Obstetrics and Gynecology; Population-based cohort study; Proportional Hazards Models; Retrospective Studies; Selective Estrogen Receptor Modulators - therapeutic use; Taiwan - epidemiology; Taiwan National Health Insurance Research Database; Tamoxifen; Tamoxifen - therapeutic use; Young Adult; Taiwan; Taiwan National Health Insurance Research Database; Breast cancer; Tamoxifen; Hyperlipidemia; Population-based cohort study
• ISSN: 1526-8209; 1938-0666; 1938-0666
• DOI: 10.1016/j.clbc.2015.03.005

The association between TMX treatment and the risk of developing hyperlipidemia remains unclear. Prolonged use of TMX is likely to reduce the risk of hyperlipidemia, which may contribute to cardiovascular risk. Other risk factors and ethnic factors should be considered to evaluate the benefits of TMX treatment and its effect on cardiovascular-related disease. The association between tamoxifen (TMX) treatment and the risk of developing hyperlipidemia remains unclear. The records of 41,726 patients with breast cancer (28,266 received TMX and 13,460 did not) were obtained from the Taiwan National Health Insurance Research Database for the period from January 2000 to December 2008. Three-fold women without breast cancer were the control group (N = 125, 178). The main end point was developing hyperlipidemia during the follow-up. During a mean follow-up of 9 years, the patients with breast cancer demonstrated a rate of developing hyperlipidemia that was 6% less (adjusted hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.90-0.97) than that of the control participants without breast cancer. Stratification by age group indicated that only women aged ≥ 55 years who were diagnosed with breast cancer exhibited a significantly reduced risk of hyperlipidemia compared with the control group. With the use of 2 types of adjusted models, we observed that the TMX users (aged ≥ 55 years) consistently exhibited a significantly lower risk of hyperlipidemia than the non-TMX users and control participants (adjusted HRs, 0.79 and 0.82 from models 1 and 2, respectively). Within the 8-year follow-up period, patients with breast cancer and 366 to 1500 days of TMX therapy and > 1500 days of TMX therapy had significantly lower risks of hyperlipidemia compared with patients with ≤ 365 days of TMX therapy (adjusted HR, 0.54; 95% CI, 0.50-0.59; adjusted HR, 0.21; 95% CI, 0.18-0.24, respectively). In Asian patients with breast cancer, TMX use was associated with reduced risks of hyperlipidemia.