Background: Selective estrogen-receptor modulators and aromatase inhibitors have become ubiquitous in the treatment of breast cancer. However, hormone therapy is a well-established thromboembolic risk factor. The purpose of this study is two-fold: (1) to further evaluate tamoxifen as a potential thrombotic risk factor and (2) to evaluate use of aromatase inhibitors as a potential novel risk factor.
Methods: Abdominally based free flaps were reviewed from January of 2008 to July of 2012. Preoperative records were used to identify patients receiving selective estrogen-receptor modulators (e.g., tamoxifen) or aromatase inhibitors before reconstruction. Patients were instructed to cease tamoxifen 2 weeks before surgery. Patients were not advised to cease their aromatase inhibitor regimen. Univariate statistical analyses included Fisher's exact test and the Mann-Whitney U test. A value of p < 0.05 denoted statistical significance.
Results: One thousand three hundred forty-seven flaps were performed on 858 patients. There were no statistically significant differences in thrombotic complications or flap failure in comparing those that did not receive preoperative hormone therapy versus those that did receive preoperative hormone therapy, nor were there significant differences specific to those receiving tamoxifen or aromatase inhibitors. A post hoc power analysis was performed with the supposition that hormone therapy exposure results in a two-fold increase in complication rate. The study power was found to be 0.863.
Conclusions: Tamoxifen may have been previously overestimated as a microvascular thrombotic risk factor. At a minimum, these data suggest that withholding tamoxifen for 2 weeks before surgery can mitigate thrombotic risk.
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http://dx.doi.org/10.1097/PRS.0000000000001127 | DOI Listing |
Eur J Nucl Med Mol Imaging
January 2025
Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
Purpose: Estrogen receptor (ER) expression and heterogeneity affect endocrine therapy efficacy. F-fluoroestradiol (F-FES) PET/CT is an effective non-invasive method to analyze systemic ER expression. This study aimed to examine the predictive/prognostic value of F-FES PET/CT for patients treated with endocrine therapy plus cyclin-dependent kinase 4/6 (CDK4/6) inhibitors.
View Article and Find Full Text PDFJACC CardioOncol
December 2024
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Background: Hormone therapies, including aromatase inhibitors and tamoxifen, are used with ovarian suppression to improve outcomes in premenopausal patients with breast cancer. Cardiovascular impacts of these treatments among premenopausal women are unknown.
Objectives: The aim of this study was to test the hypothesis that the use of aromatase inhibitors in combination with ovarian suppression, relative to tamoxifen, is associated with greater incident cardiovascular disease (CVD) risk in premenopausal breast cancer survivors.
Pak J Pharm Sci
January 2025
Department of Pediatrics, Changxing Peoples' Hospital Pediatrics, Huzhou, Zhejiang Province, China.
Recombinant human growth hormone (rhGH) injections combined with Anastrozole are increasingly used to treat adolescent idiopathic short stature (ISS), warranting further research. This study evaluated their effects on height, growth rate and adverse reactions in 72 adolescents with ISS treated at our hospital from December 2021 to December 2022. Patients were divided into a control group (rhGH alone) and a study group (rhGH + Anastrozole).
View Article and Find Full Text PDFJ Clin Med
December 2024
Global Andrology Forum, Moreland Hills, OH 44022, USA.
Hormonal factors play an essential role as an underlying causative factor of oligoasthenoteratozoospermia (OAT), and these patients can benefit from hormonal medications that modulate the hypothalamic-pituitary-gonadal axis. This review aims to outline the various medications used as hormonal therapy in treating infertile men with OAT. This manuscript focuses on essential hormonal evaluation, identifying men who would benefit from treatment, selecting the appropriate medication, determining the duration of therapy, and evaluating hormonal treatment outcomes.
View Article and Find Full Text PDFBreast Cancer Res
January 2025
Department of Epidemiology (EM, JEB) and Nutrition (KJM), Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Kresge 505-B, Boston, MA, 02115, USA.
Background: Alcohol intake is associated with a higher risk of estrogen receptor-positive (ER+) breast cancer (BC), presumably through its confirmed ability to increase sex hormone levels. Whether consuming alcohol within the recommended limit of one serving per day increases sex hormone levels among postmenopausal women taking aromatase inhibitors (AI) to inhibit estrogen production remains unknown. Therefore, we compared sex hormone levels following white wine to levels following white grape juice among ER + BC survivors taking AIs.
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