Abstract
ABSTRACT:
BACKGROUND:
Adjuvant hormonal treatment with aromatase inhibitors for postmenopausal women with early-stage breast cancer is associated with relatively few side effects but it may cause bone mass loss which can be detected with a dual-energy x-ray absorptiometry scan.
AIM:
In this study, we evaluate the skeletal effects of aromatase inhibitors in postmenopausal women with early-stage breast cancer.
PATIENTS AND METHODS:
This is an observational retrospective case-control study enrolled 70 postmenopausal women with early-stage breast cancer on adjuvant aromatase inhibitors and 70 postmenopausal control women, the two groups were compared regarding the prevalence and severity of bone mass loss by using the DXA scan of their lumbar spine.
RESULTS:
Bone mineral density was significantly lower in breast cancer cases (mean T score was (-2.50 ± 1.01) compared to the control group (mean T score was (-2.12 ± 0.79) with significant (p-value =0.014), also 60%of breast cancer cases were osteoporotic compared to 32% in the control group (p-value =0.005). Based on univariate analysis, breast cancer was associated with 2.79 folds increased probability of osteoporosis
CONCLUSION:
A significant proportion of our breast cancer patients who used aromatase inhibitors were osteoporotic.
Keywords
10. Powles TJ, Hickish T, Kanis JA, et al. Effect of tamoxifen on bone mineral density measured by dual-energy x-ray absorptiometry in healthy premenopausal and postmenopausal women. J Clin Oncol 1996; 14:78-84.
11. Bruning PF, Pit MJ, de Jong-Bakker M, et al. Bone mineral density after adjuvant chemotherapy for premenopausal breast cancer. Br J Cancer. 1990; 61 :308–10
12. K G Faulkner, C C Glüer, S Majumdar, P Lang. Noninvasive measurements of bone mass, structure, and strength: current methods and experimental techniques.
13. World Health Organization Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: technical report series 843. Geneva: WHO, 1994.
14. Kanis J A, Gluer C C, for the Committee of Scientific Advisors, International Osteoporosis Foundation. An update on the diagnosis and assessment of osteoporosis with densitometry. Osteoporos Int 200011192–202.
15. Fraenkel M , Novack V, Liel Y, Koretz M, Siris E, et al. (2013) Association between Bone Mineral Density and Incidence of Breast Cancer. PLoS ONE 8(8): e70980. doi:10.1371/journal.pone.0070980.
16. Hadji P. trial. Aromatase inhibitor-associated bone loss in breast cancer patients is distinct from postmenopausal osteoporosis. Crit Rev Oncol Hematol 2009; 69:73–82.
17. Kohlmeier, Lynn Kohlmeier (1998 ).osteoporosis– Risk Factors , Screening and Treatment.. Medscape Portals. Retrieved 2008-5-11.
18. Eastell R, Hannon RA, Cuzick J, et al. Effect of an aromatase inhibitor on BMD and bone turnover markers: 2-year results of the Anastrozole, Tamoxifen, Alone or in Combination (ATAC) trial (18233230). J Bone Miner Res2006; 21:1215–23.
)
