Lani
09-24-2007, 10:03 AM
Bones of Breast Cancer Patients Aged Prematurely by Treatment: Presented at ASBMR [Doctor's Guide]
HONOLULU, HAWAII — September 20, 2007 — Women who are under treatment for early-stage breast cancer are likely to have a low bone mineral density (BMD) and are at increased risk of osteopaenia and osteoporosis, researchers noted here at the 29th Annual Meeting of the American Society for Bone and Mineral Research.
Chemotherapy, radiation therapy, aromatase inhibitors and other treatments for breast cancer all put this population at increased risk for osteoporotic fractures, stated Pauline M. Camacho, MD, Associate Professor of Medicine, Division of Endocrinology and Metabolism, and Director, Osteoporosis and Metabolic Bone Disease Center, Loyola University Health System, Maywood, Illinois, United States.
Dr. Camacho and colleagues conducted a retrospective chart review of 238 postmenopausal women referred to their centre for the management of osteoporosis or osteopaenia.
Patients were divided into those without a history of breast cancer (174 patients), and those with early-stage breast cancer (64 patients) who were receiving or being considered for adjuvant hormonal therapy with aromatase inhibitors.
The mean age of those with breast cancer was 59.5 years compared with 64.2 years for those without. Serum 25-hydroxy-vitamin D levels were 28.7 ng/mL in those without breast cancer and 34.03 ng/mL in those with the disease. Spine T scores were lower, and femoral-neck bone mineral density (BMD) were significantly lower in controls than in those with early-stage cancer, perhaps because the cancer patients were receiving closely monitored health care, Dr. Camacho said.
More than three-quarters of both groups had at least one secondary cause of osteoporosis. The most common secondary cause was vitamin-D deficiency in both groups, which was seen in 37.5% of the breast-cancer group and 51.1% of the group without breast cancer.
A new diagnosis of a secondary cause, however, was seen more often in those with breast cancer, which Dr. Camacho said was a significant finding.
"There is a growing trend toward switching adjuvant treatment from tamoxifen to aromatase inhibitors as adjuvant treatment for breast cancer," Dr. Camacho noted. "Since there is such a high prevalence of secondary causes of osteoporosis, physicians should be cautious about prescribing or continuing these patients on adjuvant therapy with aromatase inhibitors.Tamoxifen should be considered, since it is bone-sparing," she advised.
ABSTRACT: Prevalence of Secondary Causes of Osteoporosis Among Breast Cancer Patients with Osteoporosis and Osteopenia [American Society for Bone and Mineral Research]
Purpose: The main objective of this study was to determine the prevalence of secondary causes of osteoporosis among breast cancer patients being evaluated for osteopenia (low bone mass) and osteoporosis.
Methods: We conducted a retrospective chart review of 238 postmenopausal women consecutively referred to Loyola University Medical Center Endocrinology clinics from 2000-2005, for the management of osteoporosis or osteopenia. Patients were divided into two groups: those without a history of breast cancer or NBC group (N=174), and those with breast cancer or BC group (N=64). The BC group was comprised of patients with early stage breast cancer in the midst of or considering adjuvant hormonal therapy with aromatase inhibitors. Histories and biochemical data from their initial consultation were analyzed. Statistical analysis of each patient population was performed to elucidate the prevalence of secondary causes of osteoporosis in patients with breast cancer relative to the group of patients without breast cancer.
Results: The demographics of the two groups differed in age (64.2 ± 14.2 in NBC versus 59.5 ± 10.6 in BC group, p=0.015), mean weight (63.5 ± 13.7 in NBC versus 73.62 ± 20.95 kg in BC, p <0.001), 25 OH Vitamin D levels (28.7 ± 13.1 in NBC versus 34.03 ± 15.1 ng/ml in BC, p = 0.019) and degree of bone loss (spine T score of -1.966± 1.34 in NBC versus-0.918± 1.41 in BC, p < 0.001). The presence of at least one secondary cause of osteoporosis was seen in 78.1% of the breast cancer patient group (excluding cancer-related therapies), and in 77 % of the non-breast cancer group. Newly diagnosed metabolic bone disorders were seen in 57.8% of the breast cancer population. The most common secondary cause in both groups was vitamin D deficiency, which was seen in 37.5% of the breast cancer group and 51% of the non-breast cancer group. In the BC group, this was followed by idiopathic hypercalciuria (15.6% versus 8% in NBC, trend towards higher prevalence in BC than the NBC group p=0.085), normocalcemic hyperparathyroidism (3.1%) and primary hyperparathyroidism (1.6%).
Conclusion: We found a high prevalence of secondary causes of osteoporosis among breast cancer patients undergoing or considering adjuvant hormonal therapy with aromatase inhibitors. Previously published reports of bone loss and fractures seen in patients on such agents may have been partly due to the presence of these disorders. It is prudent to obtain a baseline DXA and to screen patients with breast cancer for secondary causes of bone loss.
HONOLULU, HAWAII — September 20, 2007 — Women who are under treatment for early-stage breast cancer are likely to have a low bone mineral density (BMD) and are at increased risk of osteopaenia and osteoporosis, researchers noted here at the 29th Annual Meeting of the American Society for Bone and Mineral Research.
Chemotherapy, radiation therapy, aromatase inhibitors and other treatments for breast cancer all put this population at increased risk for osteoporotic fractures, stated Pauline M. Camacho, MD, Associate Professor of Medicine, Division of Endocrinology and Metabolism, and Director, Osteoporosis and Metabolic Bone Disease Center, Loyola University Health System, Maywood, Illinois, United States.
Dr. Camacho and colleagues conducted a retrospective chart review of 238 postmenopausal women referred to their centre for the management of osteoporosis or osteopaenia.
Patients were divided into those without a history of breast cancer (174 patients), and those with early-stage breast cancer (64 patients) who were receiving or being considered for adjuvant hormonal therapy with aromatase inhibitors.
The mean age of those with breast cancer was 59.5 years compared with 64.2 years for those without. Serum 25-hydroxy-vitamin D levels were 28.7 ng/mL in those without breast cancer and 34.03 ng/mL in those with the disease. Spine T scores were lower, and femoral-neck bone mineral density (BMD) were significantly lower in controls than in those with early-stage cancer, perhaps because the cancer patients were receiving closely monitored health care, Dr. Camacho said.
More than three-quarters of both groups had at least one secondary cause of osteoporosis. The most common secondary cause was vitamin-D deficiency in both groups, which was seen in 37.5% of the breast-cancer group and 51.1% of the group without breast cancer.
A new diagnosis of a secondary cause, however, was seen more often in those with breast cancer, which Dr. Camacho said was a significant finding.
"There is a growing trend toward switching adjuvant treatment from tamoxifen to aromatase inhibitors as adjuvant treatment for breast cancer," Dr. Camacho noted. "Since there is such a high prevalence of secondary causes of osteoporosis, physicians should be cautious about prescribing or continuing these patients on adjuvant therapy with aromatase inhibitors.Tamoxifen should be considered, since it is bone-sparing," she advised.
ABSTRACT: Prevalence of Secondary Causes of Osteoporosis Among Breast Cancer Patients with Osteoporosis and Osteopenia [American Society for Bone and Mineral Research]
Purpose: The main objective of this study was to determine the prevalence of secondary causes of osteoporosis among breast cancer patients being evaluated for osteopenia (low bone mass) and osteoporosis.
Methods: We conducted a retrospective chart review of 238 postmenopausal women consecutively referred to Loyola University Medical Center Endocrinology clinics from 2000-2005, for the management of osteoporosis or osteopenia. Patients were divided into two groups: those without a history of breast cancer or NBC group (N=174), and those with breast cancer or BC group (N=64). The BC group was comprised of patients with early stage breast cancer in the midst of or considering adjuvant hormonal therapy with aromatase inhibitors. Histories and biochemical data from their initial consultation were analyzed. Statistical analysis of each patient population was performed to elucidate the prevalence of secondary causes of osteoporosis in patients with breast cancer relative to the group of patients without breast cancer.
Results: The demographics of the two groups differed in age (64.2 ± 14.2 in NBC versus 59.5 ± 10.6 in BC group, p=0.015), mean weight (63.5 ± 13.7 in NBC versus 73.62 ± 20.95 kg in BC, p <0.001), 25 OH Vitamin D levels (28.7 ± 13.1 in NBC versus 34.03 ± 15.1 ng/ml in BC, p = 0.019) and degree of bone loss (spine T score of -1.966± 1.34 in NBC versus-0.918± 1.41 in BC, p < 0.001). The presence of at least one secondary cause of osteoporosis was seen in 78.1% of the breast cancer patient group (excluding cancer-related therapies), and in 77 % of the non-breast cancer group. Newly diagnosed metabolic bone disorders were seen in 57.8% of the breast cancer population. The most common secondary cause in both groups was vitamin D deficiency, which was seen in 37.5% of the breast cancer group and 51% of the non-breast cancer group. In the BC group, this was followed by idiopathic hypercalciuria (15.6% versus 8% in NBC, trend towards higher prevalence in BC than the NBC group p=0.085), normocalcemic hyperparathyroidism (3.1%) and primary hyperparathyroidism (1.6%).
Conclusion: We found a high prevalence of secondary causes of osteoporosis among breast cancer patients undergoing or considering adjuvant hormonal therapy with aromatase inhibitors. Previously published reports of bone loss and fractures seen in patients on such agents may have been partly due to the presence of these disorders. It is prudent to obtain a baseline DXA and to screen patients with breast cancer for secondary causes of bone loss.