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breast cancer, postmenopausal, bone density, osteoporosis

Kevin G Hegarty, Frances J Drummond, Mary Daly, Fergus Shanahan, Michael G Molloy
Gaining an understanding of factors contributing to bone quality is key to the development of effective preventative treatments for osteoporosis and reduction in osteoporotic fractures. Oestrogen is a strong regulator of bone remodelling which maintains skeletal structural integrity. The growth regulation by oestrogen in breast cancer 1 (GREB1) gene, with an as yet undefined function, is an early response gene in the oestrogen-regulated pathway. Suggestive evidence of linkage with bone mineral density (BMD) variation has been reported with D2S168, located telomeric of GREB1...
March 14, 2017: Journal of Bone and Mineral Metabolism
Jamie Stratton, Xin Hu, Pamela R Soulos, Amy J Davidoff, Lajos Pusztai, Cary P Gross, Sarah S Mougalian
PURPOSE: In postmenopausal women with breast cancer treated with aromatase inhibitors (AIs), most expert panels advise baseline bone mineral density testing with a dual-energy x-ray absorptiometry (DXA) scan repeated every 1 to 2 years. How often this recommendation is followed is unclear. METHODS: We performed a retrospective analysis of women with stage I to III breast cancer who started AI therapy from January 1, 2008, to December 31, 2010, with follow-up through December 31, 2012, by using the SEER-Medicare database...
March 7, 2017: Journal of Oncology Practice
Rebecca Pedersini, Sara Monteverdi, Gherardo Mazziotti, Vito Amoroso, Elisa Roca, Filippo Maffezzoni, Lucia Vassalli, Filippo Rodella, Anna Maria Formenti, Stefano Frara, Roberto Maroldi, Alfredo Berruti, Edda Simoncini, Andrea Giustina
BACKGROUND: The impact of long-term adjuvant therapy with aromatase inhibitors (AIs) on vertebral fracture (VF) risk is still unclear. OBJECTIVE: In this cross-sectional study, we explored the prevalence and determinants of VFs in breast cancer (BC) patients before and during AI therapy. Each woman underwent a dual-energy X-ray absorptiometry (DXA) to evaluate bone mineral density (BMD) and identify VFs by a quantitative morphometric approach. Blood samples were collected to measure serum hormone and calcium levels...
January 16, 2017: Bone
Karina Monroy-Cisneros, Julián Esparza-Romero, Mauro E Valencia, Alfonso G Guevara-Torres, Rosa O Méndez-Estrada, Iván Anduro-Corona, Humberto Astiazarán-García
BACKGROUND: Breast cancer is the most deadly malignancy in Mexican women. Although treatment has improved, it may significantly affect bone mineral status in those who receive it. The aim of this study was to assess the impact of cancer treatment on bone mineral density (BMD) and bone mineral content (BMC), in patients with breast cancer and explore the interaction of menopausal status and clinical stage with cancer treatment on such changes. METHODS: A quasi-experimental design was applied with measurements before and after a chemotherapy treatment in 40 patients with primary diagnosis of invasive breast cancer...
November 8, 2016: BMC Cancer
Shengliang Sun, Fuchao Wang, Honglei Dou, Longqiang Zhang, Jiwen Li
BACKGROUND: This study aims to compare the efficacy and safety between zoledronic acid combined with calcium and calcium alone to prevent aromatase inhibitor-associated bone loss for postmenopausal breast cancer patients receiving adjuvant letrozole. METHODS: One hundred twenty patients were randomly divided into two groups, A and B. Patients in group A (n=60) received modified radical mastectomy or breast-conserving surgery + four cycles of AC followed by T regimen (optional) + radiotherapy (optional) + letrozole 2...
2016: OncoTargets and Therapy
Kentaro Nakai
Selective estrogen receptor modulators(SERMs)have beneficial effects on the improvement of bone mineral density of the spine and hip, and decrease the vertebral fracture in postmenopausal women. Similar to patients with advanced chronic kidney disease, including dialysis patients, however, SERMs cannot decrease the risk of hip fracture, which is extremely high in Japanese dialysis patients. One of the most important disadvantages of SERMs is an increase in the risk of venous thromboembolic events and fatal stroke in high-risk groups of the Framingham Stroke Risk Score...
September 2016: Clinical Calcium
Rodríguez-Sanz María, Pineda-Moncusí Marta, Servitja Sonia, Garcia-Giralt Natalia, Martos Tamara, Tusquets Ignasi, Martínez-García Maria, Rodriguez-Morera Jaime, Diez-Perez Adolfo, Albanell Joan, Nogués Xavier
INTRODUCTION: Patients with breast cancer under aromatase inhibitor (AI) treatment often develop osteoporosis and their average bone loss rate is twice that of natural reduction during menopause, increasing fracture risk. As the current diagnostic technique based on bone mineral density (BMD) provides no information on bone quality, the Trabecular Bone Score (TBS) has been proposed to reflect bone microarchitecture status. The present study was designed to assess prospective changes in TBS and lumbar spine (LS) BMD in postmenopausal women with breast cancer at completion of AI treatment...
November 2016: Bone
Carina Ørts Christensen, Deirdre Cronin-Fenton, Trine Frøslev, Anne Pernille Hermann, Marianne Ewertz
PURPOSE: Adjuvant chemotherapy has been associated with loss of bone mineral density (BMD) either as a direct effect or due to glucocorticoids used as supportive care medication. A prospective cohort study was conducted to evaluate changes in BMD from baseline to right after completion of chemotherapy, i.e., 4 months. METHODS: Dual-imaging X-ray absorptiometry (DXA) was performed at baseline and after completing anthracycline- and taxane-based chemotherapy to measure BMD in the spine, hip, and forearm in early-stage breast cancer patients...
October 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
F Vescini, R Attanasio, A Balestrieri, F Bandeira, S Bonadonna, V Camozzi, S Cassibba, R Cesareo, I Chiodini, C Maria Francucci, L Gianotti, F Grimaldi, R Guglielmi, B Madeo, C Marcocci, A Palermo, A Scillitani, E Vignali, V Rochira, M Zini
Treatment of osteoporosis is aimed to prevent fragility fractures and to stabilize or increase bone mineral density. Several drugs with different efficacy and safety profiles are available. The long-term therapeutic strategy should be planned, and the initial treatment should be selected according to the individual site-specific fracture risk and the need to give the maximal protection when the fracture risk is highest (i.e. in the late life). The present consensus focused on the strategies for the treatment of postmenopausal osteoporosis taking into consideration all the drugs available for this purpose...
July 2016: Journal of Endocrinological Investigation
P Marcin Sowa, Martin J Downes, Louisa G Gordon
Postmenopausal women with breast cancer on aromatase inhibitor (AI) treatment are at increased risk of bone mineral density loss, which may lead to minimal trauma fractures. We examined the cost-effectiveness of dual energy X-ray absorptiometry (DXA) with antiresorptive (AR) therapy compared with fracture risk assessment, lifestyle advice, and vitamin supplementation. We used a hypothetical Markov cohort model of lifetime duration for 60-year-old women with early stage breast cancer receiving AIs. The data to inform the model came from medical literature, epidemiological reports, and costing data sets...
March 11, 2016: Journal of Bone and Mineral Metabolism
M Cepa, C Vaz
Breast cancer is the most commonly diagnosed cancer among women, but despite survival rates improvement, it is still the second major cause of cancer related death. In postmenopausal women with estrogen receptor (ER) dependent breast cancer, hormone therapy is an option, either by direct inhibition of ER using tamoxifen or by aromatase inhibition, resulting in decreased estrogen production. In this paper these two endocrine therapy approaches are compared in terms of their impact on bone health. Guidance for the prevention of bone loss and occurrence of fractures in postmenopausal women receiving AIs is also proposed...
October 2015: Acta Reumatológica Portuguesa
Na-Ra Han, Na-Rae Kim, Hyung-Min Kim, Hyun-Ja Jeong
Cysteine (Cys) is well known to be involved in oxidation-reduction reactions, serving as a source of sulfides in the body. Amino acids are known to improve menopausal symptoms and significantly reduce morbidity. This study aims to find an unrevealed effect of Cys with estrogenic and osteogenic actions. Ovariectomized (OVX) mice were treated with Cys daily for 8 weeks. Estrogen-related and osteoporosis-related factors were analyzed in the vagina, serum, and tibia. Cys was treated in estrogen receptor (ER)-positive human osteoblast-like MG-63 cells and ER-positive human breast cancer Michigan Cancer Foundation-7 (MCF-7) cells...
May 2016: Reproductive Sciences
Margarida Cepa, Carlos Vaz
Breast cancer is the most commonly diagnosed cancer among women, but despite survival rates improvement, it is still the second major cause of cancer related death. In postmenopausal women with estrogen receptor (ER) dependent breast cancer, hormone therapy is an option, either by direct inhibition of ER using tamoxifen or by aromatase inhibition, resulting in decreased estrogen production. In this paper these two endocrine therapy approaches are compared in terms of their impact on bone health. Guidance for the prevention of bone loss and occurrence of fractures in postmenopausal women receiving AIs is also proposed...
August 7, 2015: Acta Reumatológica Portuguesa
Neil Majithia, Pamela J Atherton, Jacqueline M Lafky, Nina Wagner-Johnston, Janet Olson, Shaker R Dakhil, Edith A Perez, Charles L Loprinzi, Stephanie L Hines
PURPOSE: This study was designed to explore whether zoledronic acid could prevent expected loss of bone mineral density (BMD) in postmenopausal women with pre-existing osteopenia or osteoporosis who were initiating adjuvant letrozole therapy for primary breast cancer. METHODS: Between June 2006 and July 2007, 60 postmenopausal women with estrogen and/or progesterone receptor-positive breast cancer and a BMD T-score ≤-2.0 were enrolled. Participants received letrozole 2...
March 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Hiroaki Inoue, Akira Hirano, Kaoru Ogura, Akinori Hattori, Mari Kamimura, Fumie Okubo, Hiroko Tagawa, Shiho Sakaguchi, Jun Kinoshita, Tadao Shimizu
PURPOSE: The administration of aromatase inhibitors is associated with bone loss in postmenopausal women. We assessed changes in bone mineral density (BMD) from baseline to 60 months of treatment in patients receiving anastrozole as initial adjuvant therapy. METHODS: Postmenopausal women with hormone receptor-positive breast cancer receiving anastrozole as adjuvant therapy at our center since 2004 were enrolled in this study. BMD was assessed by dual-energy X-ray absorptiometry at baseline and after 6, 12, 24, 36, 48 and 60 months...
2015: SpringerPlus
Michael Gnant, Georg Pfeiler, Peter C Dubsky, Michael Hubalek, Richard Greil, Raimund Jakesz, Viktor Wette, Marija Balic, Ferdinand Haslbauer, Elisabeth Melbinger, Vesna Bjelic-Radisic, Silvia Artner-Matuschek, Florian Fitzal, Christian Marth, Paul Sevelda, Brigitte Mlineritsch, Günther G Steger, Diether Manfreda, Ruth Exner, Daniel Egle, Jonas Bergh, Franz Kainberger, Susan Talbot, Douglas Warner, Christian Fesl, Christian F Singer
BACKGROUND: Adjuvant endocrine therapy compromises bone health in patients with breast cancer, causing osteopenia, osteoporosis, and fractures. Antiresorptive treatments such as bisphosphonates prevent and counteract these side-effects. In this trial, we aimed to investigate the effects of the anti-RANK ligand antibody denosumab in postmenopausal, aromatase inhibitor-treated patients with early-stage hormone receptor-positive breast cancer. METHODS: In this prospective, double-blind, placebo-controlled, phase 3 trial, postmenopausal patients with early hormone receptor-positive breast cancer receiving treatment with aromatase inhibitors were randomly assigned in a 1:1 ratio to receive either denosumab 60 mg or placebo administered subcutaneously every 6 months in 58 trial centres in Austria and Sweden...
August 1, 2015: Lancet
Peyman Hadji
Osteoporosis is one of the most frequent diseases in postmenopausal women, leading to an increased fracture risk due to the physiologic loss of the bone protective effects of estrogen. Hereby, several risk factors for fracture such as prevalent fracture, low bone mineral density (BMD), age, low body mass index, family history, tendency to falls, smoking, use of SSRIs, glucocorticoid use etc. have been identified. In addition, the further reduction in endogenous estrogens with chemotherapy (CHT), GnRH analoga or aromatase inhibitors (AIs) continuously increases fracture risk...
2015: BoneKEy Reports
Nina D Wagner-Johnston, Jeff A Sloan, Heshan Liu, Ann E Kearns, Stephanie L Hines, Suneetha Puttabasavaiah, Shaker R Dakhil, Jacqueline M Lafky, Edith A Perez, Charles L Loprinzi
BACKGROUND: Postmenopausal women with breast cancer receiving aromatase inhibitors are at an increased risk of bone loss. The current study was undertaken to determine whether upfront versus delayed treatment with zoledronic acid (ZA) impacted bone loss. This report described the 5-year follow-up results. METHODS: A total of 551 postmenopausal women with breast cancer who completed tamoxifen treatment and were undergoing daily letrozole treatment were randomized to either upfront (274 patients) or delayed (277 patients) ZA at a dose of 4 mg intravenously every 6 months...
August 1, 2015: Cancer
Carolyn L Smith, Richard J Santen, Barry Komm, Sebastian Mirkin
A number of available treatments provide relief of menopausal symptoms and prevention of postmenopausal osteoporosis. However, as breast safety is a major concern, new options are needed, particularly agents with an improved mammary safety profile. Results from several large randomized and observational studies have shown an association between hormone therapy, particularly combined estrogen-progestin therapy, and a small increased risk of breast cancer and breast pain or tenderness. In addition, progestin-containing hormone therapy has been shown to increase mammographic breast density, which is an important risk factor for breast cancer...
June 18, 2014: Breast Cancer Research: BCR
Michael Knauer, Beat Thürlimann
Several solid tumors like breast cancer tend to spread to the bone, where the microenvironment is especially receptive to the tumor by special interactions between bone cells and tumor cells. Bone metastases often lead to skeletal-related events with significant morbidity and mortality. The therapy of bone metastases and osteoporosis with bisphosphonates (BPs) has been established many years ago as a standard treatment. In the adjuvant setting, cancer treatment-induced bone loss is a frequent cause of morbidity, and prevention and treatment of this condition with BPs and the monoclonal antibody denosumab are also well established...
October 2014: Breast Care
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