title: Effects of exemestane, anastrozole and tamoxifen on bone mineral density and bone turnover markers in postmenopausal early breast cancer patients: results of N-SAS BC 04, the TEAM Japan substudy.
abstract: BACKGROUND
  Use of aromatase inhibitors in women with postmenopausal breast cancer accompanies risks of bone loss. We evaluated changes in bone mineral density (BMD) and bone turnover markers in patients treated with exemestane, anastrozole or tamoxifen for hormone-sensitive postmenopausal early breast cancer.
  
  
  METHODS
  Sixty-eight patients enrolled in the Tamoxifen Exemestane Adjuvant Multinational Japan bone substudy were randomly assigned to receive tamoxifen, exemestane or anastrozole. During a 2-year study period, lumbar spine BMD was measured using dual-energy X-ray absorptiometry, and urinary type I collagen cross-linked N-telopeptide (NTX) and serum bone-specific alkaline phosphatase (BAP) were also measured.
  
  
  RESULTS
  BMD at 2 years of treatment was higher in tamoxifen patients compared with exemestane and anastrozole patients; however, the intergroup difference was not significant (p = 0.2521 and p = 0.0753, respectively). BMD was higher in exemestane patients compared with anastrozole patients; however, the intergroup difference was not significant (p = 0.7059 and p = 0.8134, respectively). NTX and BAP were significantly lower in tamoxifen patients compared with exemestane and anastrozole patients at 1 and 2 years of treatment (p < 0.05).
  
  
  CONCLUSIONS
  Tamoxifen may provide better bone protection compared with exemestane or anastrozole. The effect of exemestane and anastrozole on bone loss may be comparable in Japanese postmenopausal women.
authors: Aihara Hospital, Minoh, Japan. aiharat@aiharabreast.com
authors: T
authors: T
authors: Aihara
authors: K
authors: K
authors: Suemasu
authors: H
authors: H
authors: Takei
authors: Y
authors: Y
authors: Hozumi
authors: M
authors: M
authors: Takehara
authors: T
authors: T
authors: Saito
authors: S
authors: S
authors: Ohsumi
authors: N
authors: N
authors: Masuda
authors: Y
authors: Y
authors: Ohashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000077384:Anastrozole; D000730:Androstadienes / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects*; D001862:Bone Resorption; D001842:Bone and Bones / Q000187:drug effects; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009570:Nitriles / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D017698:Postmenopause; D013629:Tamoxifen / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D014230:Triazoles / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000730:Androstadienes; D000970:Antineoplastic Agents; D009570:Nitriles; D014230:Triazoles; D013629:Tamoxifen; D000077384:Anastrozole; C056516:exemestane