Risk Of Venous Thromboembolism In Patients With Breast Cancer Treated With Tamoxifen Or The Third Generation Aromatase Inhibitor:A Meta-analysis

Objective: To systematically evaluate the effect of tamoxifen on thromboembolism in postmenopausal women with breast cancer, so as to Provide decision-making evidence for clinical treatmeat. Methods: PubMed, Chinese Biomedical Database(CBM), Wanfang Data,and CNKI were searched from January 1, 2000 to June 7, 2015,and the studies as references of eligible articles were also searched. Included studies were randomized controlled trials and patients were treated with tamoxifen or the third generation aromatase inhibitor in postmenopausal women with breast cancer. According to including criteria, articles were evaluated by "bias risk assessment" tool which Cochrane Handbook 5.1 recommended. Data of these studies were extraeted via the data extraction form.Software RevMan 5.2 was used to the heterogeneity of trials, and analysis the data using fixed or random effect model to pool the Relative risk and 95%CI, The funnel plot was used to discuss the publication bias. Results: A total of 9 RCTs involving 23367 participants were included, and the results of meta-analyses showed that: Compared with the third generation aromatase inhibitors(alone or combine with tamoxifen),Patients receiving tamoxifen had a significantly increased risk of VTEs(RR, 1.78; 95%CI, 1.49 to 2.13; P< 0.00001).No matter used in neoadjuvant endocrine therapy after operation or in rescue therapy, tamoxifen is associated with a significant increase in the risk of VTEs in postmenopausal women With breast Cancer.