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A Journal on Internal Medicine

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Minerva Medica 2013 April;104(2):141-53


language: English

Long-term cardiac and vascular disease outcomes following adjuvant tamoxifen therapy: current understanding of impact on physiology and overall survival

Onitilo A. A. 1, 2, Kar P. 3, Engel J. M. 4, Glurich I. 5

1 Department of Hematology/Oncology, Marshfield Clinic Weston Center, Weston, WI, USA; 2 School of Population Health, University of Queensland, Brisbane, Australia; 3 Department of Medicine, Allegiance Health, Jackson, MI, USA; 4 Department of Hematology/Oncology, Marshfield Clinic Cancer Care, Stevens Point, WI, USA; 5 Office of Scientific Writing and Publication, Marshfield Clinic Research Foundation, Marshfield, WI, USA


The relative impact of tamoxifen therapy in women with breast cancer on overall survival, especially as it pertains to cardiac and cardiovascular outcomes, remains under debate in the literature. This review focuses specifically on outcomes of studies that examined large clinical trials with longest duration in patient follow-up relative to these parameters in which compliance with therapy could be documented. Over time, evidence supports potential cardioprotective effects and capacity of adjuvant therapy to improve lipid profiles in women treated with tamoxifen. While some benefit to cardiac health is supported, outcomes related to cardiovascular events remain variable across studies and challenging to interpret. In summary, overall survival in women treated with tamoxifen over time has increasingly shown a trend towards positive outcomes in the context of evaluation of post-treatment cardiac and vascular health. Potential mechanisms underlying the cardioprotective effects of tamoxifen are briefly discussed.

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