Effects Of(neo) Adjuvant Chemotherapy And Aromatase Inhibitors On Serum Lipid Levels In Patients With Early Breast Cancer

Purposes:To study the effects of(neo)adjuvant chemotherapy and adjuvant aromatase inhibitors on serum lipid profiles in patients with early breast cancer,and to compare the effects of different drugs on serum lipid levels in patients.Methods:To investigate the effects of chemotherapy on blood lipid profiles,patients with early-stage breast cancer who were treated and followed up at the Second Affiliated Hospital of Zhejiang University from January 2012 to December 2017 were included.A total of 805 patients were included in the study analyzing the effect of chemotherapy in lipid profiles.Lipid profiles of patients who received surgery without chemotherapy were measured at 3 months before surgery,3 months,6 months and 12 months after surgery.Serum lipid levels of patients in the chemotherapy group(including neoadjuvant chemotherapy group and adjuvant chemotherapy group)were collected before the first chemotherapy,before the last chemotherapy and 6 months after chemotherapy.To study the effects of aromatase inhibitors on blood lipid profiles,116 cases of postmenopausal breast cancer patients who take aromatase inhibitors from January 2013 to December 2015 in the Second Affiliated Hospital of Zhejiang University.Serum lipid levels were collected before treatment,at 3,6,12,and 24 months after treatment.Lipid profile measurements included total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C).Results:For the adjuvant chemotherapy group,the TC,TG and LDL-C levels increased significantly during chemotherapy,while HDL-C levels decreased significantly during chemotherapy.Six months after chemotherapy,levels of TC and LDL-C dropped significantly from the last chemotherapy or even lower than before.In contrast,HDL-C levels rose significantly from the last chemotherapy and returned to pre-chemotherapy levels.However,TG levels remained higher six months after chemotherapy than before.In the neoadjuvant chemotherapy group,TG and LDL-C levels increased significantly during chemotherapy,as did the adjuvant chemotherapy group.However,TC levels did not increase significantly during chemotherapy.TG levels were higher six months after chemotherapy than before.In the comparison of different chemotherapy regimens,the reduction of HDL-C was more significant in anthracycline combined with taxane.TC and LDL-C levels in patients under 40 years of age were significantly higher during chemotherapy than in patients over 40 years of age.For aromatase inhibitors treatment group,letrozole significantly increased TC and TG levels,while exemestane significantly decreased TG levels.In studies comparing the effects of different aromatase inhibitors on blood lipids,the level of HD-C in the exemestane group decreased more than the other two groups,but there was no significant difference among the three groups at 24 months of treatment.At 3,6,and 24 months after administration,the level of TG in the exemestane group and the anastrozole group decreased more significantly than that in the letrozole group,and there was no significant difference in other blood lipid levels between the groups.Conclusions:Chemotherapy has a temporary effect on blood lipid levels in breast cancer patients.TG,LDL-C,and HDL-C levels change for the worse after chemotherapy,but LDL-C and HDL-C return to pre-chemotherapy levels after chemotherapy,however,TG levels were still higher than before chemotherapy.The effect of different chemotherapy regimens on serum lipid level in breast cancer patients was not significant.Chemotherapy had a greater effect on lipid levels in young breast cancer patients.Letrozole was more potent in raising TG levels,while exemestane was more potent in lowering HDL-C levels.The effect of blood lipid in anastrozole group was relatively mild.