Managing the risk of osteoporosis in women with a history of early breast cancer.
Estrogen is known to play an important role in skeletal health. Female breast cancer patients who receive treatments that reduce estrogen levels, such as aromatase inhibitors, may increase their risk of developing osteoporosis and their risk of fracture. Clinical guidelines enable the physician to assess the risk of osteoporosis by patient history and physical examination. For patients identified as being at risk, it is necessary to test bone mineral density (BMD), using the result to determine which patients require treatment. Two groups can be identified as requiring BMD assessment according to general guidelines: patients < 45 years old who become menopausal due to treatment, and breast cancer patients receiving aromatase inhibitors. Bisphosphonates appear to be the logical treatment of choice for breast cancer patients, as they do not interact with the estrogen receptor. Although not all women receiving aromatase inhibitors will require additional treatment for bone health, postmenopausal women with a history of breast cancer at risk of osteoporosis should be identified, monitored, and managed according to practice guidelines.
Ravdin
Peter M
PM
University of Texas Health Science Center San Antonio, Texas 78259-2307, USA. pmravdin@aol.com
D000367:Age Factors; D000970:Antineoplastic Agents / Q000009:adverse effects*; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008594:Menopause, Premature / Q000378:metabolism; D010024:Osteoporosis / Q000139:chemically induced* / Q000188:drug therapy* / Q000517:prevention & control; D018570:Risk Assessment; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013629:Tamoxifen / Q000627:therapeutic use
D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors; D004164:Diphosphonates; D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen