Bone Abstracts

Aim: Evaluate the differences with densitometry after 2-year treatment in patients with breast cancer and LBMD.

Materials and methods: A 2 year duration longitudinal study was done in patients diagnosed with breast cancer sent to the Rheumatology Osteoporosis Unit in Hospital d’Ontinyent, who required supplements of calcium and vitamin D+bisphosphonates after a risk fracture study. Socio-demographic data, breast tumor characteristics, risk factors for osteoporosis and fragile fractures, definite diagnosis and the treatment initiated were registered. Differences between mean values obtained in BMD of lumbar, total femoral, and femoral neck, were evaluated with student’s t-test study.

Results: 61 patients were studied, with an average age of 59 years old (37–79 years). All had unilateral breast cancer, while none had metastases. Treatments received were: radical mastectomy (56%), radiotherapy (64%), chemotherapy (71%), hormonotherapy (30%), tamoxifen (41%), GnRH analogues (13%), and aromatase inhibitors (90%). High-risk osteoporosis was diagnosed in 6 patients, osteoporosis in 19 patients and osteopenia in 26 patients. In spinal X-rays, 26 patients had >1 vertebral collapse and 4 of them >1 vertebral fracture. Treatment with supplements of calcium and vitamin D was initiated in 85.2%, and bisphosphonates (oral or i.v.) in 41 patients, as follow: ibandronate (15), risedronate (16), alendronate (8), and zoledronate (2).

After a 2-year follow-up, only one patient had developed metastases, 75.4% continued with aromatase inhibitors and only two had abandoned treatment. None suffered new vertebral collapse or fracture, only one suffered from other fractures.

Conclusions: Patients with breast cancer that require initiating treatment for fragile risk fracture present good treatment compliance. Treatment including supplements of calcium and vitamin D and bisphosphonates during two years improves the mineral bone density, finding statistically significative differences in femoral neck (BMD, T-score, Z-score) and in all localizations (lumbar, femoral neck and total femoral) while using Z-score.