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News
Sticking with hormone therapy pays off — but comes with a cardiometabolic cost. A large prospective study found that postmenopausal women with early-stage HR-positive breast cancer who adhered to aromatase inhibitors (AIs) for 5 years had higher 10-year risks of hypertension, dyslipidemia, and diabetes — yet still had lower overall mortality than non-adherent patients. The takeaway: keep the therapy, but watch the heart.
Breast cancer hormone therapy boosts survival but raises heart and metabolic risks
Staying on hormone therapy for breast cancer is clearly worth it — but it doesn't come without trade-offs. A prospective cohort study of over 8,300 postmenopausal women with early-stage HR-positive breast cancer found that 5-year adherence to aromatase inhibitors (AIs) was linked to meaningfully higher 10-year risks of hypertension, dyslipidemia, and diabetes compared to non-adherent patients. Tamoxifen adherence, by contrast, was only associated with elevated hypertension risk — suggesting AIs carry a heavier cardiometabolic burden.
The silver lining? Despite those risks, long-term adherence to either therapy was tied to significantly lower all-cause, breast cancer-specific, and cardiovascular mortality. Researchers speculate that adherent patients may simply be more engaged with the healthcare system, enabling better risk factor management overall.
By the Numbers
Why it matters: With over 4 million breast cancer survivors in the US, these findings are a call to action for oncology and primary care teams to pair endocrine therapy with proactive cardiometabolic screening — keeping patients alive and healthy for the long haul.
