Key result
Endocrine therapies significantly disrupted lipid metabolism in early-stage HR+ breast cancer patients, with SERM ± OFS causing the greatest rise in abnormal LDL-C from 12.11% to 23.34%.
Why the study?
Breast cancer patients face abnormal lipid metabolism and increased CVD risk from endocrine therapies, but evaluation was needed in Chinese patients with early-stage HR+ breast cancer to inform personalized treatments.
Does endocrine therapy increase the risk of lipid abnormalities and cardiovascular diseases in patients with early-stage hormone receptor-positive breast cancer?
Cohort (n=11,537)
Yes
Does endocrine therapy increase the risk of lipid abnormalities and cardiovascular diseases in patients with early-stage hormone receptor-positive breast cancer?
Absolute Event Rate: 23.34% vs 12.11%
Endocrine therapies in early-stage breast cancer are associated with significant lipid metabolism disruption and increased cardiovascular disease incidence, highlighting the need for enhanced cardiovascular monitoring in this population.
Supports lipid monitoring in Chinese early HR+ BC patients on ET; leaves open prospective validation and generalizability.
BACKGROUND: Breast cancer (BC) patients face abnormal lipid metabolism and increased cardiovascular disease (CVD) risk due to endocrine therapies (ETs). This study evaluates CVD incidence and lipid abnormalities in Chinese patients with early-stage hormone receptor-positive (HR+) BC to inform personalized treatments. METHODS: Data from female patients aged 18-80 years with stage I-III HR + BC registered in the National Cancer Center Oncology Information Database (NCCOID) (2013-2018) were analyzed. Outcomes included lipid profile changes, CVD incidence, and five-year survival rates. RESULTS: Among 11,537 patients, ETs significantly disrupted lipid metabolism, increasing abnormal total cholesterol, triglycerides, LDL-C, and HDL-C levels. Nonsteroidal aromatase inhibitors (NSAI) ± ovarian function suppression (OFS) led to the largest increase in abnormal total cholesterol (10.26 to 17.32%), while selective estrogen receptor modulators (SERM) ± OFS caused the greatest rises in triglycerides (16.07 to 25.86%), LDL-C (12.11 to 23.34%), and HDL-C (10.86 to 17.23%). Only 3.82% of patients received lipid-lowering therapy. ETs were associated with higher CVD incidence, including hypertension, myocardial infarction, and atrial fibrillation, but five-year survival rates did not differ significantly across ET regimens (P > 0.05). CONCLUSION: ETs may be associated with alterations in lipid metabolism and a potential increase in CVD risk in early-stage HR + BC patients. These findings highlight the relevance of enhanced lipid monitoring and cardiovascular risk management to support optimized treatment outcomes in the Chinese population.
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Zeng et al. (2025) conducted a cohort in Early-stage hormone receptor-positive breast cancer (n=11,537). Endocrine therapies (SERM ± OFS, NSAI ± OFS, AI ± OFS, OFS) vs. Pre-treatment baseline was evaluated on Abnormal LDL-C levels (SERM ± OFS group). Endocrine therapies significantly disrupted lipid metabolism in early-stage HR+ breast cancer patients, with SERM ± OFS causing the greatest rise in abnormal LDL-C from 12.11% to 23.34%.
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