Effects of selective estrogen receptor modulators on lipid metabolism in patients with breast cancer: A systematic review and meta-analysis.

BACKGROUND

Selective estrogen receptor modulators (SERMs) have certain effects on lipid metabolism; however, the results of various studies remain controversial. We conducted a meta-analysis to summarize the existing evidence from cohort studies and randomized controlled trials (RCTs) on the effect of SERM treatment on lipid metabolism in breast cancer patients.

METHODS

We conducted a comprehensive search of PubMed, Embase, Cochrane, EBSCO, and the Web of Science databases through January 31, 2026, to identify articles focused on the effects of SERMs on lipid metabolism. Each study included the effect size and 95% confidence interval (95% CI) of the relationship between SERMs and lipid metabolism. Subgroup analyses were also performed to explore potential.

RESULTS

A total of 19 studies (13 RCTs and 6 cohort studies) were included in the meta-analysis. SERMs showed significant differences from other breast cancer treatment methods in terms of total cholesterol (TC) (SMD = -0.70; 95% CI: -0.91, -0.50), triglycerides (TG) (SMD = 0.32; 95% CI: 0.06, 0.59), low-density lipoprotein (LDL-C) (SMD = -0.76; 95% CI: -1.02, -0.50), and the risk of fatty liver occurrence (RR = 1.57; 95% CI: 1.13, 2.18).

CONCLUSIONS

SERMs exhibited significant efficacy in lowering LDL-C and TC; however, they may increase the risk of developing fatty liver. Clinical decision-making should involve a comprehensive evaluation of individual patient characteristics to optimize personalized treatment strategies.