title: No increased venous thromboembolism risk in Asian breast cancer patients receiving adjuvant tamoxifen.
abstract: Tamoxifen is an effective endocrine treatment for early breast cancer (EBC) but increases the risk of venous thromboembolism. Whether Asian EBC patients (pts) bear the same risk when treated with adjuvant tamoxifen is uncertain. EBC pts diagnosed between 2004 and 2009 were selected from a population database in Taiwan. The pts were followed up from the index date to December 31, 2011 to collect events of deep vein thrombosis (DVT) and pulmonary embolism (PE). Cumulative incidence rates and hazard ratios (HRs) were used to compare the risk between pts treated with and without tamoxifen. In addition, comorbidities were included in an adjusted model of the risk of DVT and PE. A total of 28,029 EBC pts, including 17,843 (63.8 %) in the tamoxifen group and 10,155 (36.2 %) in the nontamoxifen group, were analyzed. The 7-year cumulative incidence rates for DVT and PE were 2.58 and 0.32 % in the tamoxifen group and 2.51 and 0.32 % in the nontamoxifen group (P = 0.92 for DVT, P = 0. 65 for PE), respectively. The HR for the nonadjusted and adjusted models showed no differences in DVT and PE risks between the tamoxifen and nontamoxifen groups. The uterine cancer risk was significantly increased in the pts receiving tamoxifen (adjusted HR = 2.79, P < 0.001), suggesting tamoxifen compliance. The risks of developing DVT and PE are not increased in Asian EBC pts receiving adjuvant tamoxifen. Ethnicity differences should be considered when discussing optimal endocrine treatments with EBC pts.
authors.affiliation: Department of Oncology, National Taiwan University Hospital, 7, Chung-Shan South Rd., Taipei, 10002, Taiwan.
authors.forename: Tom Wei-Wu
authors.initials: TW
authors.lastname: Chen
authors.forename: Ho-Min
authors.initials: HM
authors.lastname: Chen
authors.forename: Ching-Hung
authors.initials: CH
authors.lastname: Lin
authors.forename: Chiun-Sheng
authors.initials: CS
authors.lastname: Huang
authors.forename: Ann-Lii
authors.initials: AL
authors.lastname: Cheng
authors.forename: Mei-Shu
authors.initials: MS
authors.lastname: Lai
authors.forename: Yen-Shen
authors.initials: YS
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D012307:Risk Factors; D020845:Selective Estrogen Receptor Modulators / Q000009:adverse effects*; D013629:Tamoxifen / Q000009:adverse effects*; D054556:Venous Thromboembolism / Q000139:chemically induced* / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000139:chemically induced / Q000453:epidemiology
chemical_list: D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen