The influence of chemotherapy on bone mineral density, quantitative ultrasonometry and bone turnover in pre-menopausal women with breast cancer.
BACKGROUND
The effects of doxorubicin/cyclophosphamide (A/C; 6 cycles) chemotherapy on bone mineral density (BMD), quantitative ultrasonography (QUS) and bone turnover markers in pre-menopausal women with oestrogen receptor-negative breast cancer (BC) were compared with age-matched controls.


METHODS
Among 106 women (BC=53, controls=53), BMD (spine and hip), QUS (calcaneus and phalanges) and bone marker levels were measured at baseline, 6 and 12 months. Correlations between parameters were determined by Spearman's rho.


RESULTS
All BC patients became amenorrhoeic after chemotherapy and remained so for the duration of treatment. BC patients had significant bone loss at all sites (P.005) and significant increases in bone turnover (P.05). There were significant correlations between BMD, QUS and bone markers (P.05).


CONCLUSIONS
Results confirm A/C's deleterious influence on bone health in pre-menopausal women with BC and established QUS's utility for monitoring bone effects. Large-scale longitudinal studies are needed to further understand and prevent bone changes following chemotherapy.
Department of Endocrinology, Reproductive Medicine, and Osteoporosis, Philipps-University of Marburg, Baldingerstrasse, 35034 Marburg, Germany. hadji@med.uni-marburg.de
Peyman
P
Hadji
May
M
Ziller
Carolin
C
Maskow
Ute
U
Albert
Matthias
M
Kalder
D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D016723:Bone Remodeling / Q000187:drug effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D002111:Calcaneus / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D003520:Cyclophosphamide / Q000009:adverse effects; D004164:Diphosphonates / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects; D005260:Female; D006615:Hip / Q000000981:diagnostic imaging; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008875:Middle Aged; D017697:Premenopause; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced / Q000150:complications; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D014463:Ultrasonography; D055815:Young Adult; D000077211:Zoledronic Acid
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D004317:Doxorubicin; D003520:Cyclophosphamide