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The efficacy of a comprehensive bone health program in maintaining bone mineral density in postmenopausal women with early-stage breast cancer treated with endocrine therapy: real-world data

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Abstract

Background

Aromatase inhibitors (AI) are the gold standard treatment option for hormone-sensitive postmenopausal women with breast cancer. Several studies had documented the accelerated bone loss associated with AI.

Aims

In this study, we present real-world data describing the efficacy of implementing a comprehensive bone health program to maintain bone mineral density (BMD) in postmenopausal patients with early-stage breast cancer treated with AI.

Methods

A comprehensive bone health program that includes counseling, exercise, nutritional advice, vitamin D supplements and, when needed, intravenous bisphosphonate infusion was implemented following the initiation of endocrine therapy with AI. Postmenopausal women with hormone-sensitive, early-stage breast cancer treated with endocrine therapy using AI were retrospectively identified. All patients had BMD measurements before and at least 1 year after ET initiation.

Results

A total of 210 patients were included, median (range) age 67 (43–86) years. At baseline, osteoporosis was documented in 38 (18.1%) and osteopenia in 101 (48.1%) patients. Despite the known negative effect of AI, 32 (84.2%) patients with baseline osteoporosis and 69 (68.3%) of those with osteopenia, had a stable or better BMD. On the other hand, 41 (57.7%) of those with normal baseline BMD had a drop in their follow up BMD, p < 0.001. Vertebral fractures were reported in 3 (11.1%) patients with osteoporosis compared to none in patients with normal BMD, p = 0.021.

Conclusions

Despite the known negative effect of ET on bone health of breast cancer patients, implementing a comprehensive bone health program stabilized or improved BMD.

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Availability of data and material

Data used in this study can be made available upon reasonable request to the corresponding author.

Prior presentation

Data was presented, as a poster, at the annual San Antonio Breast Cancer Symposium held virtually 8–11 Dec 2020.

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Authors and Affiliations

  1. Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan

    Hikmat Abdel-Razeq, Razan Mansour, Rayan Bater & Shrouq Tbayshat

  2. School of Medicine, University of Jordan, Queen Rania Al Abdullah Street, P.O. Box 1269, Amman, 11941, Jordan

    Hikmat Abdel-Razeq & Shereen Abu Jaradeh

  3. Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan

    Ula Al-Rasheed, Noor Mashhadani & Akram Al-Ibraheem

  4. Istishari Hospital, Amman, Jordan

    Rashid Abdel-Razeq

Authors
  1. Hikmat Abdel-Razeq
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  2. Ula Al-Rasheed
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  3. Noor Mashhadani
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  4. Akram Al-Ibraheem
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  5. Rashid Abdel-Razeq
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Correspondence to Hikmat Abdel-Razeq.

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The study was approved by King Hussein Cancer Center IRB.

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Abdel-Razeq, H., Al-Rasheed, U., Mashhadani, N. et al. The efficacy of a comprehensive bone health program in maintaining bone mineral density in postmenopausal women with early-stage breast cancer treated with endocrine therapy: real-world data. Ir J Med Sci 191, 2511–2515 (2022). https://doi.org/10.1007/s11845-021-02897-5

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  • DOI: https://doi.org/10.1007/s11845-021-02897-5

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