Lipid concentrations in postmenopausal women on letrozole after 5 years of tamoxifen: An NCIC CTG MA.17 sub-study

Kishor M. Wasan, Paul E. Goss, P. Haydn Pritchard, Lois Shepherd, Dongsheng Tu, James N. Ingle

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


To evaluate changes in serum lipid parameters (cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and lipoprotein(a) [Lp(a)]), in postmenopausal women receiving letrozole after tamoxifen therapy. MA.17L is a sub-study of MA.17, a double-blind, placebo-controlled trial of extended adjuvant letrozole. Eligible postmenopausal women were non-hyperlipidemic and not on lipid-lowering drugs. This analysis considers the 183 patients on the letrozole arm. Lipid parameters evaluated at baseline, 6 months, 12 months, and yearly thereafter until completion of 5 years of letrozole. The median duration of letrozole treatment was 5.0 years with a range from 0.03 to 6.05 years. After 5 year tamoxifen, patients on letrozole experienced significant increases from baseline in total cholesterol, LDL cholesterol, and Lp(a) at all study time points but no statistically significant changes in triglycerides. Specifically, a statistically significant increase was found at 60 months in total cholesterol [mean percentage change from baseline (PC) 5.27; p = 0.003], HDL cholesterol (mean PC 6.75; p = 0.003), LDL cholesterol (mean PC 10.02; p = 0.001), Lp(a) (mean PC 105.95; p < 0.0001). 103 (56 %) women in the study had clinically significantly elevated levels of Lp(a) (106 % above baseline) after 5 years of therapy. The results were similar after excluding the 21 % of patients who had ever received anti-lipid treatment. Significant increases in total cholesterol, HDL cholesterol, LDL cholesterol, and, most notably, Lp(a) in postmenopausal women were observed following 5 years of adjuvant letrozole treatment and after 5 years of tamoxifen therapy and such patients should have monitoring of their lipid levels in clinical practice.

Original languageEnglish (US)
Pages (from-to)769-776
Number of pages8
JournalBreast Cancer Research and Treatment
Issue number3
StatePublished - Dec 2012


  • 5-year follow-up
  • Letrozole
  • Postmenopausal women
  • Primary breast cancer
  • Serum lipids
  • Tamoxifen

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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