The effects on lipid serum levels of a 2-year adjuvant treatment with exemestane after tamoxifen in postmenopausal women with early breast cancer

Eur J Intern Med. 2008 Dec;19(8):592-7. doi: 10.1016/j.ejim.2007.05.016. Epub 2008 Apr 1.


Background: The third-generation aromatase inhibitor exemestane represents a new development in the treatment of estrogen-positive breast cancer. The aim of this study was to evaluate the effects on lipid profile and body composition of the shift from tamoxifen to exemestane.

Methods: After 2-3 years of tamoxifen adjuvant treatment, 68 postmenopausal women were randomly assigned to either continue tamoxifen 20 mg/day (n = 35) or to switch to exemestane 25 mg/day (n = 33).

Results: No significant changes in lipid profile were found in patients continuing on tamoxifen. In the exemestane group, serum HDL-cholesterol (HDL-C) and triglycerides (TG) decreased significantly (p < 0.01) and serum LDL-cholesterol (LDL-C) increased significantly (p < 0.05) with respect to baseline. The difference between the two groups was significant. Moreover, in the exemestane group, fat mass (FM) and fat-free mass (FFM) showed an opposite trend, which determined a progressive and significant increase in the FFM/FM ratio.

Conclusion: This study shows that the choice of first-line treatment or adjuvant therapy for breast cancer should also take the individual lipid and body composition profile into account.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Androstadienes / therapeutic use*
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Aromatase Inhibitors / therapeutic use
  • Biomarkers / blood
  • Body Composition
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / metabolism
  • Chemotherapy, Adjuvant
  • Cholesterol, HDL / blood
  • Cholesterol, HDL / drug effects
  • Cholesterol, LDL / blood
  • Cholesterol, LDL / drug effects
  • Cohort Studies
  • Estrogen Receptor Modulators / therapeutic use
  • Female
  • Humans
  • Lipids / blood*
  • Middle Aged
  • Postmenopause / blood*
  • Single-Blind Method
  • Tamoxifen / therapeutic use*
  • Treatment Outcome
  • Triglycerides / blood


  • Androstadienes
  • Antineoplastic Agents
  • Antineoplastic Agents, Hormonal
  • Aromatase Inhibitors
  • Biomarkers
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Estrogen Receptor Modulators
  • Lipids
  • Triglycerides
  • Tamoxifen
  • exemestane