EFFECTS OF CHEMOTHERAPY-INDUCED CASTRATION ON SERUM-LIPIDS AND APOPROTEINS IN PREMENOPAUSAL WOMEN WITH NODE-POSITIVE BREAST-CANCER

The purpose of this study was to determine the effect of adjuvant chem otherapy on serum lipids and lipoproteins in premenopausal nonmetastat ic breast cancer patients. Fifty-nine premenopausal breast cancer pati ents were treated with adjuvant chemotherapy comprising cyclophosphami de, methotrexate, and 5-fluorouracil. Levels of serum FSH, LH, and est radiol; fasting plasma levels of total cholesterol, high density lipop rotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), t riglyceride, and apolipoprotein A-I, A-II, and B levels; and lipoprote in(a) [Lp(a)] were measured before treatment and 12 months after the b eginning of chemotherapy. The changes in serum lipids after chemothera py correlated significantly to changes in menstruation. Total choleste rol, LDL, and HDL cholesterol levels increased significantly only in p atients with chemotherapy-induced ovarian dysfunction. Changes in apo B paralleled those in LDL and apo A-I and A-II HDL cholesterol. The se rum concentration of Lp(a) increased significantly only in patients wh o developed permanent amenorrhea. There were no significant changes in triglyceride levels. Chemotherapy per se has no effect on serum lipid s unless associated with induction of ovarian dysfunction. Ovarian fai lure after chemotherapy has an unfavorable effect on serum total and L DL cholesterol, apo B, and Lp(a) levels, but a favorable effect on HDL cholesterol.