ECTS2016 Poster Presentations Cancer and bone: basic, translational and clinical (37 abstracts)
Long-term effect of aromatase inhibitor on bone mineral density, trabecular bone score, and hip geometry in postmenopausal women with primary breast cancer
A Ram Hong 1 , Jung Hee Kim 1 , Kyung-Hun Lee 1 , Tae Yong Kim 1 , Seock-Ah Im 1 , Tae-You Kim 1 , Hyung-Gon Moon 2 , Wonshik Han 2 , Dong-Young Noh 2 , Sang Wan Kim 1 & Chan Soo Shin 1
1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; 2Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
Background: Aromatase inhibitors (AIs) increase the risk of fracture in patients with breast cancer. Therefore, we aimed to evaluate the long-term effects of AIs on bone health in postmenopausal women with primary breast cancer.
Patients and methods: We performed a retrospective longitudinal observational study in patients with breast cancer who were treated by AIs for ≧3 years (baseline T-score >–2.5). Patients with previous anti-osteoporosis treatment or those who were given bisphosphonate during the AI treatment were excluded from the analysis. We serially assessed bone mineral density (BMD), lumbar spine trabecular bone score (TBS), and hip geometry using dual-energy X-ray absorptiometry.
Results: Of the 321 included patients (mean age: 58.8 years), 112 patients (34.9%) underwent previous chemotherapy. The BMD significantly decreased from baseline to 5 years at the lumbar spine (–6.15%), femur neck (–7.12%), and total hip (–6.53%). Lumbar spine TBS also significantly decreased from baseline to 5 years (–2.12%) independent of lumbar spine BMD. The annual loss of lumbar spine BMD and TBS slowed down after 3 years and 1 year of treatment, respectively, although there was a relatively constant loss of BMD at the femur neck and total hip up to 4 years. Cross-sectional area, cross-sectional moment of inertia, minimal neck width, femur strength index, and section modulus significantly decreased, although the bucking ratio increased over the treatment period (all P <0.001); these changes were independent of total hip BMD. No significant differences were observed in time-group interactions for BMD, TBS, and hip geometry according to the presence of previous chemotherapy.
Conclusion: Long-term adjuvant AI treatment negatively influenced BMD and bone quality in patients with breast cancer. This study suggests that a monitoring and preventive strategy could be beneficial for patients with breast cancer who are starting or receiving AI treatment.
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Bone Abstracts
ISSN 2052-1219 (online)
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