J Korean Surg Soc.  1998 Nov;55(5):661-669.

Effects of Tamoxifen on Bone Mineral Metabolism in Women with Breast Cancer

• Lee HB
• Suh YJ
• Jung SS
• Kim IC

Abstract

BACKGROUND: Tamoxifen, a synthetic antiestrogen, increases disease-free and overall survival when used as adjuvant therapy for primary breast cancer. Because it is given for long periods, it is important to know whether tamoxifen affects bone mineral metabolism in women. However few reports on this topic have been published in Korea.
METHODS
We classified patients into four subgroups by age, hormone receptor status, and menstrual status, and during a five-year randomized, uncontrolled clinical investigation we studied retrospectively the effects of tamoxifen on biochemical measures of bone mineral metabolism in 112 women with axillary-node-negative breast cancer.
RESULTS
In all four subgroups, neither the serum calcium nor the phosphorus level showed any fluctuation beyond the reference range. Serum alkaline phosphatase (ALP) decreased one year after the operation in all subgroups, and then increased afterwards in the reference range. However, women in the under 40-years-old subgroup and in the both estrogen and progesterone receptor negative subgroup showed a prominent rise in the upper value of the reference range up to 436 IU/l. In the 60 or older subgroup, ALP values showed some fluctuations similar to those for the both estrogen and progesterone receptor positive subgroup.
CONCLUSIONS
We think that treatment with tamoxifen may be associated with preservation of bone minerals in women after menopause, in women 60 and older, and in women with a positive estrogen and progesterone receptor. Also, this effect probably can help to prevent or to delay the development of osteoporosis in these women with breast cancer, but a possible relation with a decrease in the risk of fractures still remains to be evaluated.

Keyword

Breast cancer; Tamoxifen; Bone; Mineral; Calcium; Phosphorus; Alkaline phosphatase; Metabolism

MeSH Terms

Alkaline Phosphatase
Breast Neoplasms*
Breast*
Calcium
Estrogen Receptor Modulators
Estrogens
Female
Humans
Korea
Menopause
Metabolism*
Minerals
Osteoporosis
Phosphorus
Receptors, Progesterone
Reference Values
Retrospective Studies
Tamoxifen*
Alkaline Phosphatase
Calcium
Estrogen Receptor Modulators
Estrogens
Minerals
Phosphorus
Receptors, Progesterone
Tamoxifen