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Due to the extended duration of endocrine therapy, patients often face both on-treatment side effectssuch as hot flashes, fatigue, muscle pain, mood changes, vaginal symptoms, gastrointestinal issues, headaches, weight gain, and bone density lossas well as long-term effects, including an increased risk of heart disease and stroke, osteoporosis, memory problems or difficulty with concentration, secondary cancers, sexual dysfunction, chronic fatigue, joint pain and stiffness, and metabolic changes [23, 24]

The PLS-DA and heat map in Figure 1 show that resistant cells treated continuously with 1 M tamoxifen (4+1), a concentration that is often measured in patients (24), showed different metabolic clusters compared to the other two resistant groups (50 and 35x6) and the control (tamoxifen-sensitive) group, indicating that they had markedly different metabolic characteristics ( Figure 1A )

10.1016/j.exger.2006.10.003 88 Sastre-SerraJ.Nadal-SerranoM.PonsD

Narcissist: She does everything and anything because it revolves around her, and takes the self-posturing as morally righteous because she wants to be loved by others

Circ Res 90, 143150 (2002)

The subcutaneous tissue, or hypodermis, is the layer of fat and connective tissue located right beneath the skin and above the muscle layer