Abstract
Adjuvant therapy in postmenopausal women with breast cancer may contribute to the expression of underlying cardiovascular disease or expose the heart to additional toxicities. Tamoxifen remains an important component of endocrine therapy for breast cancer. although major clinical trials of the aromatase inhibitors (Als) anastrozole. letrozole. and exemestane suggest that these agents are more effective and better tolerated alternatives to tamoxifen. The Als inhibit the conversion of androgens to estrogen in postmenopausal women; consequently. their mechanism of action differs from that of tamoxifen. Accordingly. although it has been observed that tamoxifen has some favorable effects on cardiovascular risk. such as reducing total cholesterol levels. because of its partial estrogen-agonist properties. no such effects exist for the Als. Some studies. particularly those that compare the Als with tamoxifen. have suggested a less favorable impact of adjuvant Al therapy on cardiovascular risk. Comorbid conditions. including cardiovascular disease. emerge as competing causes of death as women with breast cancer continue to live longer. and the potential impact of adjuvant therapies on cardiovascular risk becomes an increasingly important consideration for clinicians.
| Original language | English |
|---|---|
| Pages (from-to) | 1813-1826 |
| Number of pages | 14 |
| Journal | Cancer |
| Volume | 115 |
| Issue number | 9 |
| DOIs | |
| State | Published - May 1 2009 |
| Externally published | Yes |
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Keywords
- Anastrozole
- Aromatase inhibitors
- Breast cancer
- Cardiovascular disease
- Exemestane
- Letrozole
- Tamoxifen
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
A woman's heart. / Ewer, Michael S.; Glück, Stefan.
In: Cancer, Vol. 115, No. 9, 01.05.2009, p. 1813-1826.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A woman's heart
AU - Ewer, Michael S.
AU - Glück, Stefan
PY - 2009/5/1
Y1 - 2009/5/1
N2 - Adjuvant therapy in postmenopausal women with breast cancer may contribute to the expression of underlying cardiovascular disease or expose the heart to additional toxicities. Tamoxifen remains an important component of endocrine therapy for breast cancer. although major clinical trials of the aromatase inhibitors (Als) anastrozole. letrozole. and exemestane suggest that these agents are more effective and better tolerated alternatives to tamoxifen. The Als inhibit the conversion of androgens to estrogen in postmenopausal women; consequently. their mechanism of action differs from that of tamoxifen. Accordingly. although it has been observed that tamoxifen has some favorable effects on cardiovascular risk. such as reducing total cholesterol levels. because of its partial estrogen-agonist properties. no such effects exist for the Als. Some studies. particularly those that compare the Als with tamoxifen. have suggested a less favorable impact of adjuvant Al therapy on cardiovascular risk. Comorbid conditions. including cardiovascular disease. emerge as competing causes of death as women with breast cancer continue to live longer. and the potential impact of adjuvant therapies on cardiovascular risk becomes an increasingly important consideration for clinicians.
AB - Adjuvant therapy in postmenopausal women with breast cancer may contribute to the expression of underlying cardiovascular disease or expose the heart to additional toxicities. Tamoxifen remains an important component of endocrine therapy for breast cancer. although major clinical trials of the aromatase inhibitors (Als) anastrozole. letrozole. and exemestane suggest that these agents are more effective and better tolerated alternatives to tamoxifen. The Als inhibit the conversion of androgens to estrogen in postmenopausal women; consequently. their mechanism of action differs from that of tamoxifen. Accordingly. although it has been observed that tamoxifen has some favorable effects on cardiovascular risk. such as reducing total cholesterol levels. because of its partial estrogen-agonist properties. no such effects exist for the Als. Some studies. particularly those that compare the Als with tamoxifen. have suggested a less favorable impact of adjuvant Al therapy on cardiovascular risk. Comorbid conditions. including cardiovascular disease. emerge as competing causes of death as women with breast cancer continue to live longer. and the potential impact of adjuvant therapies on cardiovascular risk becomes an increasingly important consideration for clinicians.
KW - Anastrozole
KW - Aromatase inhibitors
KW - Breast cancer
KW - Cardiovascular disease
KW - Exemestane
KW - Letrozole
KW - Tamoxifen
UR - http://www.scopus.com/inward/record.url?scp=65649119341&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=65649119341&partnerID=8YFLogxK
U2 - 10.1002/cncr.24219
DO - 10.1002/cncr.24219
M3 - Article
C2 - 19235248
AN - SCOPUS:65649119341
VL - 115
SP - 1813
EP - 1826
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 9
ER -