Abstract
Serum lipids and apolipoprotein levels were measured in twenty postmenopausal women with primary breast cancer, before and three months after tamoxifen therapy (10 mg twice a day). Tamoxifen caused a significant reduction in total serum cholesterol (10%;P < 0.02), and in low-density lipoprotein cholesterol (17%;P < 0.01), and a significant 47 % increase in the subclass 2 of the high density lipoprotein cholesterol (P< 0.01). In addition, tamoxifen caused a 16% increase in apolipoprotein A-I, a 12% decrease in apolipoprotein B (P < 0.05), and a 37% reduction in the serum concentration of lipoprotein(a) (P< 0.01). These results show that tamoxifen brings about an important improvement in serum lipid profile.
References
Gray R: Tamoxifen: how boldly to go where no women have gone before. J Natl Cancer Inst 85: 1358–1360, 1993
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
McDonald CC, Stewart HJ: Fatal myocardial infarction in the Scottish adjuvant tamoxifen trial. BMJ 303: 435–437, 1991
Jordan VC, Fritz NF, Tormey DC: Long-term adjuvant therapy with tamoxifen: Effects on sex hormone binding globulin and antithrombin III. Cancer Res 47: 4517–4519, 1987
Sakai F, Cheix F, Clavel M, Colon J, Mayer M, Pommatau E, Saez S: Increases in steroid binding globulins induced by tamoxifen in patients with carcinoma of the breast. J Endocrinol 76: 219–226, 1978
Walsh BW, Schiff I, Rosner B, Greenberg L, Ravnikar V, Sacks FM: Effects of postmenopausal estrogen replacement on the concentration and metabolism of plasma lipoproteins. N Engl J Med 325: 1196–1204, 1991
Schaefer EJ, Foster DM, Zech LA, Lindgren FT, Brewer HB, Levy RI: The effects of estrogen administration on plasma lipoprotein metabolism in premenopausal females. J Clin Endocrinol Metab 57: 262–267, 1983
Henderson BE, Ross RK, Paganini-Hill A, Mack TM: Estrogen use and cardiovascular disease. Am J Obstet Gynecol 154: 1181–1186, 1986
Love RR, Newcomb PA, Wiebe DA, Surawicz TS, Jordan VC, Carbone PP, DeMets DL: 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
Love RR, Wiebe DA, Newcomb PA, Cameron L, Leventhal H, Jordan VC, Feyzi J, DeMets DL: Effects of tamoxifen on cardiovascular risk factors in postmenopausal women. Ann Intern Med 115: 860–864, 1991
Dewar JA, Horobin JM, Preece PE, Tavendale R, Tunstall-Pedoe H, Wood RAB: Long term effects of tamoxifen on blood lipid values in breast cancer. BMJ 305: 225–226, 1992
Uterman G: Lipoprotein(a). In: Scriver CR, Beaudet AL, Sly WS, Vall D (eds) The metabolic and molecular basis of inherited disease. McGraw-Hill, New York, 1995, pp 1887–1912
Kostner GM, Avogaro P, Cazzolato G, Marth E, Bittolo-Bon G, Quici GB: Lipoprotein Lp(a) and the risk for myocardial infarction. Atherosclerosis 38: 51–58, 1981
Dahlen GH, Guyton JR, Attar M, Farmer JA, Kautz JA, Gotto AM: Association of levels of Lp(a), plasma lipids, and other lipoproteins with coronary artery disease documented by angiography. Circulation 74: 758–765, 1986
Wade DP: Lipoprotein(a). Curr Opin Lipidol 4: 244–249, 1993
Gurakar A, Hoeg JM, Kostner GM, Papadopoulas NM, Brewer HB: Levels of lipoprotein Lp(a) decline with neomycin and niacin treatment. Atherosclerosis 57: 293–301, 1985
Nabulsi AA, Folsom AR, White A, Patsch W, Heiss G, Wu KK: Association of hormone-replacement therapy with various cardiovascular risk factors in postmenopausal women. N Engl J Med 328: 1069–1075, 1993
Henriksson P, Angelin B, Berglund L: Hormonal regulation of serum Lp(a) levels. Opposite effects after estrogen treatment and orchidectomy in males with prostatic carcinoma. J Clin Invest 89: 1166–1171, 1992
Farish E, Rolton HA, Barnes JF, Hart DM: Lipoprotein(a) concentration in postmenopausal women taking norethisterone. BMJ 303: 694, 1991
Crook D, Sidhu M, Seed M, O'Donnell M, Stevenson JC: Lipoprotein Lp(a) levels are reduced by danazol, an anabolic steroid. Atherosclerosis 92: 41–47, 1992
Albers JJ, Taggart HM, Applebaum-Bowden D, Haffner S, Chestnut CH, Hazzard WR: Reduction of lecithin-cholesterol acyl-transferase, apolipoprotein D and the Lp(a) lipoprotein with the anabolic steroid stanozolol. Biochim Biophys Acta 795: 293–296, 1984
Olivecrona H, Ericsson S, Berglund L, Angelin B: Increased concentration of serum lipoprotein(a) in response to growth hormone treatment. BMJ 306: 1726–1727, 1993
Shewmon DA, Stock JL, Abusamra LC, Kristan MA, Baker S, Heiniluoma KM: Tamoxifen decreases lipoprotein(a) in patients with breast cancer. Metabolism 43: 531–532, 1994
Shewmon DA, Stock JL, Rosen CJ, Heiniluoma KM, Hogue MM, Morrison A, Doyle EM, Ukena T, Weale V, Baker S: Tamoxifen and estrogen lower circulation lipoprotein(a) concentration in healthy postmenopausal women. Arterioscler Thromb 14: 1586–1593, 1994
Warnick GR, Benderson JM, Albers JJ: Quantitation of High Density Lipoprotein subclasses after separation by dextran sulfate and Mg2+ precipitation. Clin Chem 28: 1574–1582, 1982
Friedewald WT, Levy RI, Fredrickson DS: Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18: 499–502, 1972
Rutqvist LE, Mattsson A: Cardiac and thromboembolic morbidity among postmenopausal women with early-stage breast cancer in randomized trial of adjuvant tamoxifen. J Natl Cancer Inst 85: 1398–1406, 1993
Bagdade JD, Wolter J, Subbaibah PV, Ryan W: Effects of tamoxifen on plasma lipids and lipoprotein composition. J Clin Endocrinol Metab 70: 1132–1135, 1990
Bruning PF, Bonfrer JMG, Hart AAM, de Jong-Bakker M, Linders D, van Loon J, Nooyen WJ: Tamoxifen, serum lipoproteins and cardiovascular risk. Br J Cancer 58: 497–499, 1988
Miller NE: Associations of high-density lipoprotein subclasses and apolipoproteins with ischemic heart disease and coronary atherosclerosis. Am Heart J 113: 589–597, 1987
Catherino WH, Jordan VC: A risk-benefit assessment of tamoxifen therapy. Drug Safety 8: 381–397, 1993
Kedar RP, Bourne TH, Powles TJ, Collins WP, Ashley SE, Cosgrove DO, Cambell S: Effects of tamoxifen on uterus and ovaries of postmenopausal women in a randomised breast cancer prevention trial. Lancet 343: 1318–1321, 1994
Fisher B, Constantino JP, Redmond CK, Fisher ER, Wickerham DL, Cronin WM: Endometrial cancer in tamoxifentreated breast cancer patients: findings from the National Adjuvant Breast Cancer and Bowel Project (NSAPB-14). J Natl Cancer Inst 86: 527–537, 1994
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Morales, M., Santana, N., Soria, A. et al. Effects of tamoxifen on serum lipid and apolipoprotein levels in postmenopausal patients with breast cancer. Breast Cancer Res Tr 40, 265–270 (1996). https://doi.org/10.1007/BF01806815
Issue Date:
DOI: https://doi.org/10.1007/BF01806815