Adjuvant chemotherapy improves outcome of patients with early breast cancer. However, chemotherapy may be associated with long term toxicities, there is limited data on the incidence of dyslipidaemias after adjuvant chemotherapy. In this prospective cross-sectional study, the objectives were to determine the incidence of dyslipidaemias and the associated factors among young premenopausal Chinese breast cancer patients after adjuvant chemotherapy.
Eligibility criteria include Chinese breast cancer patients of stage I-III, younger than 45 years at diagnosis, having received adjuvant chemotherapy, within 3-10 years after the diagnosis of breast cancer. Patients' characteristics, anti-cancer treatments, body weight and height at the time of breast cancer diagnosis (i.e. prior to chemotherapy) were collected. At study entry, patients had body weight and fasting blood lipids determined; incidence of chemotherapy-related amenorrhea (CRA) and menopause were determined based on detailed menstrual history. Dyslipidaemia was defined according to US National Cholesterol Education Program. Analysis was conducted to identify factors associated with dyslipidaemias.
280 patients were studied; the median time from breast cancer diagnosis was 5.0 years. 91.1% developed CRA; 48.9% had become menopausal and 10% were peri-menopausal. At the time of study entry, the mean weight gain was 1.8 kg; 63.2% had gained weight by >2%; 52.1% were overweight/obese. Abnormal total-cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride levels occurred 34.3%, 56.1%, 6.6% and 22.9% respectively. Increase in BMI categories to overweight/obese and older age were associated with hypercholesterolaemia. Tamoxifen was associated with reduced risk, while older age, corticosteroid premedication and having increase in BMI categories were associated with increased risk of abnormal LDL-cholesterol.
At a median of 5 years after breast cancer diagnosis and adjuvant chemotherapy, dyslipidaemias were frequent. Clinicians need to increase awareness of this aspect and interventional studies including lifestyle modifications are warranted to optimize long-term care for these patients.
Clinical trial identification
Legal entity responsible for the study
Chinese University of Hong Kong
Hong Kong Cancer Fund and Madam Diana Hon Fun Kong Donation for Cancer Research
All authors have declared no conflicts of interest.