title: The effects of adjuvant chemotherapy on bone density in postmenopausal women with early breast cancer.
abstract: OBJECTIVE
  Adjuvant chemotherapy for breast cancer can have adverse effects on bone. We investigated the effects of adjuvant chemotherapy on bone mineral density in postmenopausal women with early-stage breast cancer.
  
  
  METHODS
  We performed a chart review of all our breast center patients who had spine or hip bone density measured by dual-energy X-ray absorptiometry at our institution after treatment for stage I or II breast cancer. Patients who had other causes of metabolic bone disease were excluded. Multivariate regression analysis was used to adjust for confounding factors. Results were expressed as age-adjusted standard deviation units (Z scores).
  
  
  RESULTS
  Of the 130 eligible women, 36 (28%) received adjuvant chemotherapy and 94 (72%) did not. Mean adjusted bone density scores in both the hip (0.65 SD units; 95% confidence interval [CI]: 0.32 to 0.98 SD units; P = 0.0002) and spine (0.60 SD units; 95% CI: 0.01 to 1.19 SD units; P = 0.05) were significantly lower in patients who had received adjuvant chemotherapy compared with those who had not.
  
  
  CONCLUSIONS
  Women who were postmenopausal when they developed breast cancer and who received adjuvant chemotherapy had lower bone density than those who did not. Whether this effect is caused by adjuvant chemotherapy remains to be determined.
authors.affiliation: Department of Skeletal Health, The John Wayne Cancer Institute at Saint John's Hospital, 2200 Santa Monica Boulevard, Santa Monica, CA 90404, USA. greepn@jwci/org
authors.forename: Nancy C
authors.initials: NC
authors.lastname: Greep
authors.forename: Armando E
authors.initials: AE
authors.lastname: Giuliano
authors.forename: Nora M
authors.initials: NM
authors.lastname: Hansen
authors.forename: Tami
authors.initials: T
authors.lastname: Taketani
authors.forename: He-Jing
authors.initials: HJ
authors.lastname: Wang
authors.forename: Frederick R
authors.initials: FR
authors.lastname: Singer
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000494:pharmacology*; D015519:Bone Density / Q000187:drug effects*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000503:physiopathology*; D017024:Chemotherapy, Adjuvant; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D017698:Postmenopause; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents