Lifestyle factors and cardiometabolic risk in breast cancer patients under different hormones therapy

Background Although cardiometabolic risks associated with hormonal therapies are well-studied, research on lifestyle factors in hormone-dependent breast cancer (BC) patients remains scarce. Objective The aim was to evaluate and compare lifestyle and cardiometabolic markers in tamoxifen (TAM) or aromatase inhibitors (AIs) treated BC patients. Methods A total of 132 hormone-dependent BC patients, aged 55 ± 11 years, receiving TAM or AIs, underwent comprehensive metabolic assessments, including anthropometric parameters, daily energy intake, physical activity levels, dietary quality (MEDAS index), and cardiometabolic markers. Results AIs patients had higher body mass index (BMI), waist circumference (WC), and daily energy intake, with lower energy expenditure and physical activity, compared to TAM patients (p < 0.05). Both groups had unbalanced diets, high in simple carbohydrates and saturated fats, with significantly lower Mediterranean diet (MD) adherence in AIs group ( p < 0.05). After adjustment for confounding factors, only associations with total cholesterol (TC) (β = 0.48, p < 0.001), LDL-C (β = 0.52, p < 0.001), and TC/HDL-C and LDL-C/HDL-C ratios remained significant. Additionally, correlations were found between hormone therapy duration and TC (r = 0.227, p = 0.009), LDL-C (r = 0.184, p = 0.03), BMI (r = 0.219, p = 0.01), and WC (r = 0.166, p = 0.05). Conclusion Our findings support the hypothesis that lifestyle parameters, in interaction with hormonal treatments, may exacerbate cardiometabolic risk in breast cancer patients. These observations underscore the importance of comprehensive management that addresses lifestyle-related factors.