Dosage-dependent reduction of macular pigment optical density in female breast cancer patients receiving tamoxifen adjuvant therapy

Dosage-dependent reduction of macular pigment optical density in female breast cancer patients receiving tamoxifen adjuvant therapy

by I-Liang Lim, Angela Voon Pei Loo, Visvaraja Subrayan, Tsung Fei Khang, Mee Hoong See, Adlinda Alip, Nur Aishah Mohd Taib  

The Breast June 2018 Volume 39, Pages 117–122

It is now increasingly common for breast cancer patients to receive adjuvant tamoxifen therapy for a period of up to 10 years. As survival rate increases, managing tamoxifen ocular toxicities is important for patients' quality of life. Macular pigments in photoreceptor cells protect against free radical damage, which can cause macular degeneration. By reducing macular pigment concentration, tamoxifen may increase the risk of macular degeneration. Here, we compared macular pigment optical density (MPOD) and central macular thickness between breast cancer patients on tamoxifen adjuvant therapy (n = 70), and a control group (n = 72).

Tamoxifen and Aromatase inhibitors as potential perioperative thrombotic risk factors in free flap breast reconstruction

Tamoxifen and Aromatase inhibitors as potential perioperative thrombotic risk factors in free flap breast reconstruction. Plastic and Reconstructive Surgery, April 2015 Vol. 135(4), p.670(e)-79(e).


Mirzabiegi, M.N., et al.


http://journals.lww.com/plasreconsurg/Fulltext/2015/04000/Tamoxifen__Selective_Estrogen_
Receptor_Modulators_.6.aspx


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.

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.

Tamoixfen increases the risk of microvascular flap complications in patients undergoing microvascular breast reconstruction

Tamoixfen increases the risk of microvascular flap complications in patients undergoing microvascular breast reconstruction. Plastic & reconstructive surgery, Feb 2012, Vol. 129(2), p. 305-314.

Kelley, B.P., et al.

http://journals.lww.com/plasreconsurg/Fulltext/2012/02000/Tamoxifen_Increases_the_Risk_of_Microvascular_Flap.3.aspx

Tamoxifen citrate (tamoxifen) has been associated with increased rates of thromboembolic events, prompting concerns that it may increase the risk of complications after microvascular breast reconstruction. Some centers have implemented protocols to temporarily stop tamoxifen before microvascular breast reconstruction. The authors sought to determine whether this practice is warranted.