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01-04-2017 | Original Article

Long-term effect of aromatase inhibitors on bone microarchitecture and macroarchitecture in non-osteoporotic postmenopausal women with breast cancer

Authors: A. R. Hong, J. H. Kim, K. H. Lee, T. Y. Kim, S. A. Im, T. Y. Kim, H. G. Moon, W. S. Han, D. Y. Noh, S. W. Kim, C. S. Shin

Published in: Osteoporosis International | Issue 4/2017

Abstract

Summary

In non-osteoporotic postmenopausal women with breast cancer, aromatase inhibitors (AIs) negatively affected bone mineral density (BMD), lumbar spine trabecular bone score (TBS) as a bone microarchitecture index, and hip geometry as a bone macroarchitecture index.

Introduction

AIs increase the risk of fracture in patients with breast cancer. Therefore, we aimed to evaluate the long-term skeletal effects of AIs in postmenopausal women with primary breast cancer.

Methods

We performed a retrospective longitudinal observational study in non-osteoporotic patients with breast cancer who were treated with AIs for ≥3 years (T-score >−2.5). Patients with previous anti-osteoporosis treatment or those who were given bisphosphonate during AI treatment were excluded from the analysis. We serially assessed BMD, lumbar spine TBS, and hip geometry using dual-energy X-ray absorptiometry.

Results

BMD significantly decreased from baseline to 5 years at the lumbar spine (−6.15%), femur neck (−7.12%), and total hip (−6.35%). Lumbar spine TBS also significantly decreased from baseline to 5 years (−2.12%); this change remained significant after adjusting for lumbar spine BMD. The annual loss of lumbar spine BMD and TBS slowed after 3 and 1 year of treatment, respectively, although there was a relatively constant loss of BMD at the femur neck and total hip for up to 4 years. The cross-sectional area, cross-sectional moment of inertia, minimal neck width, femur strength index, and section modulus significantly decreased, although the buckling ratio increased over the treatment period (all P < 0.001); these changes were independent of total hip BMD.

Conclusions

Long-term adjuvant AI treatment negatively influenced bone quality in addition to BMD in patients with breast cancer. This study suggests that early monitoring and management are needed in non-osteoporotic patients with breast cancer who are starting AIs.

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Title: Long-term effect of aromatase inhibitors on bone microarchitecture and macroarchitecture in non-osteoporotic postmenopausal women with breast cancer
Authors: A. R. Hong
J. H. Kim
K. H. Lee
T. Y. Kim
S. A. Im
T. Y. Kim
H. G. Moon
W. S. Han
D. Y. Noh
S. W. Kim
C. S. Shin
Publication date: 01-04-2017
Publisher: Springer London
Published in: Osteoporosis International / Issue 4/2017
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-016-3899-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long-term effect of aromatase inhibitors on bone microarchitecture and macroarchitecture in non-osteoporotic postmenopausal women with breast cancer

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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