Changes in bone mineral density in women with breast cancer receiving aromatase inhibitor therapy

Marilyn L. Kwan, Song Yao, Cecile A. Laurent, Janise M. Roh, Charles P. Quesenberry, Lawrence H. Kushi, Joan C. Lo

Research output: Contribution to journalArticle

Abstract

Purpose: We assessed bone mineral density (BMD) change with aromatase inhibitor (AI) treatment in a contemporary cohort of women with breast cancer treated in Kaiser Permanente Northern California. Methods: Percent and estimated annual percent changes in BMD at the total hip and lumbar spine were examined in 676 women receiving AI therapy who had two serial BMD reports available (at least 1 year apart) before and after AI initiation (N = 317) or during continued AI therapy (N = 359). BMD changes were examined at the total hip and lumbar spine and compared by age and clinical subgroups. Results: Women experienced BMD declines after AI initiation or continued therapy, with median annual percent change − 1.2% (interquartile range, IQR − 2.4 to − 0.1%) at the hip and − 1.0% (IQR − 2.3 to 0.1%) at the spine after AI initiation, and − 1.1% (IQR − 2.4 to 0.1%) at the hip and − 0.9% (IQR − 2.4 to 0.5%) at the spine during continued therapy. Higher levels of bone loss were observed among younger (< 55 years) compared with older (≥ 75 years) women at the hip (− 1.6% vs. − 0.8%) and at the spine (− 1.5% vs. − 0.5%) after AI initiation, and at the hip (− 1.4% vs. − 1.2%) and at the spine (− 2.4% vs. − 0.001%) during continued therapy. Conclusions: Small but consistent declines in total hip and lumbar spine BMD were present in breast cancer patients following AI therapy initiation or continued AI therapy. Although the overall rates of osteoporosis were low, greater estimated levels of annual bone loss were evident among women < 55 years.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalBreast Cancer Research and Treatment
DOIs
StateAccepted/In press - Dec 16 2017
Externally publishedYes

Fingerprint

Aromatase Inhibitors
Bone Density
Breast Neoplasms
Hip
Spine
Therapeutics
Bone and Bones
Osteoporosis

Keywords

  • Aromatase inhibitor
  • Bone mineral density
  • Breast cancer
  • Endocrine therapy
  • Osteoporosis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Kwan, M. L., Yao, S., Laurent, C. A., Roh, J. M., Quesenberry, C. P., Kushi, L. H., & Lo, J. C. (Accepted/In press). Changes in bone mineral density in women with breast cancer receiving aromatase inhibitor therapy. Breast Cancer Research and Treatment, 1-8. https://doi.org/10.1007/s10549-017-4626-5

Changes in bone mineral density in women with breast cancer receiving aromatase inhibitor therapy. / Kwan, Marilyn L.; Yao, Song; Laurent, Cecile A.; Roh, Janise M.; Quesenberry, Charles P.; Kushi, Lawrence H.; Lo, Joan C.

In: Breast Cancer Research and Treatment, 16.12.2017, p. 1-8.

Research output: Contribution to journalArticle

Kwan, Marilyn L. ; Yao, Song ; Laurent, Cecile A. ; Roh, Janise M. ; Quesenberry, Charles P. ; Kushi, Lawrence H. ; Lo, Joan C. / Changes in bone mineral density in women with breast cancer receiving aromatase inhibitor therapy. In: Breast Cancer Research and Treatment. 2017 ; pp. 1-8.
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abstract = "Purpose: We assessed bone mineral density (BMD) change with aromatase inhibitor (AI) treatment in a contemporary cohort of women with breast cancer treated in Kaiser Permanente Northern California. Methods: Percent and estimated annual percent changes in BMD at the total hip and lumbar spine were examined in 676 women receiving AI therapy who had two serial BMD reports available (at least 1 year apart) before and after AI initiation (N = 317) or during continued AI therapy (N = 359). BMD changes were examined at the total hip and lumbar spine and compared by age and clinical subgroups. Results: Women experienced BMD declines after AI initiation or continued therapy, with median annual percent change − 1.2{\%} (interquartile range, IQR − 2.4 to − 0.1{\%}) at the hip and − 1.0{\%} (IQR − 2.3 to 0.1{\%}) at the spine after AI initiation, and − 1.1{\%} (IQR − 2.4 to 0.1{\%}) at the hip and − 0.9{\%} (IQR − 2.4 to 0.5{\%}) at the spine during continued therapy. Higher levels of bone loss were observed among younger (< 55 years) compared with older (≥ 75 years) women at the hip (− 1.6{\%} vs. − 0.8{\%}) and at the spine (− 1.5{\%} vs. − 0.5{\%}) after AI initiation, and at the hip (− 1.4{\%} vs. − 1.2{\%}) and at the spine (− 2.4{\%} vs. − 0.001{\%}) during continued therapy. Conclusions: Small but consistent declines in total hip and lumbar spine BMD were present in breast cancer patients following AI therapy initiation or continued AI therapy. Although the overall rates of osteoporosis were low, greater estimated levels of annual bone loss were evident among women < 55 years.",
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AU - Kwan, Marilyn L.

AU - Yao, Song

AU - Laurent, Cecile A.

AU - Roh, Janise M.

AU - Quesenberry, Charles P.

AU - Kushi, Lawrence H.

AU - Lo, Joan C.

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N2 - Purpose: We assessed bone mineral density (BMD) change with aromatase inhibitor (AI) treatment in a contemporary cohort of women with breast cancer treated in Kaiser Permanente Northern California. Methods: Percent and estimated annual percent changes in BMD at the total hip and lumbar spine were examined in 676 women receiving AI therapy who had two serial BMD reports available (at least 1 year apart) before and after AI initiation (N = 317) or during continued AI therapy (N = 359). BMD changes were examined at the total hip and lumbar spine and compared by age and clinical subgroups. Results: Women experienced BMD declines after AI initiation or continued therapy, with median annual percent change − 1.2% (interquartile range, IQR − 2.4 to − 0.1%) at the hip and − 1.0% (IQR − 2.3 to 0.1%) at the spine after AI initiation, and − 1.1% (IQR − 2.4 to 0.1%) at the hip and − 0.9% (IQR − 2.4 to 0.5%) at the spine during continued therapy. Higher levels of bone loss were observed among younger (< 55 years) compared with older (≥ 75 years) women at the hip (− 1.6% vs. − 0.8%) and at the spine (− 1.5% vs. − 0.5%) after AI initiation, and at the hip (− 1.4% vs. − 1.2%) and at the spine (− 2.4% vs. − 0.001%) during continued therapy. Conclusions: Small but consistent declines in total hip and lumbar spine BMD were present in breast cancer patients following AI therapy initiation or continued AI therapy. Although the overall rates of osteoporosis were low, greater estimated levels of annual bone loss were evident among women < 55 years.

AB - Purpose: We assessed bone mineral density (BMD) change with aromatase inhibitor (AI) treatment in a contemporary cohort of women with breast cancer treated in Kaiser Permanente Northern California. Methods: Percent and estimated annual percent changes in BMD at the total hip and lumbar spine were examined in 676 women receiving AI therapy who had two serial BMD reports available (at least 1 year apart) before and after AI initiation (N = 317) or during continued AI therapy (N = 359). BMD changes were examined at the total hip and lumbar spine and compared by age and clinical subgroups. Results: Women experienced BMD declines after AI initiation or continued therapy, with median annual percent change − 1.2% (interquartile range, IQR − 2.4 to − 0.1%) at the hip and − 1.0% (IQR − 2.3 to 0.1%) at the spine after AI initiation, and − 1.1% (IQR − 2.4 to 0.1%) at the hip and − 0.9% (IQR − 2.4 to 0.5%) at the spine during continued therapy. Higher levels of bone loss were observed among younger (< 55 years) compared with older (≥ 75 years) women at the hip (− 1.6% vs. − 0.8%) and at the spine (− 1.5% vs. − 0.5%) after AI initiation, and at the hip (− 1.4% vs. − 1.2%) and at the spine (− 2.4% vs. − 0.001%) during continued therapy. Conclusions: Small but consistent declines in total hip and lumbar spine BMD were present in breast cancer patients following AI therapy initiation or continued AI therapy. Although the overall rates of osteoporosis were low, greater estimated levels of annual bone loss were evident among women < 55 years.

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KW - Bone mineral density

KW - Breast cancer

KW - Endocrine therapy

KW - Osteoporosis

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