title: Bone health in a prospective cohort of postmenopausal women receiving aromatase inhibitors for early breast cancer.
abstract: OBJECTIVE
  Baseline bone health in postmenopausal women is poorly characterized in prospective series of early breast cancer (EBC) patients candidates to aromatase inhibitor (AI) therapy. Our objective is to comprehensively evaluate bone health in a prospective clinical cohort of patients recruited prior to adjuvant AI therapy, with the aim of establishing potential AI impact on bone loss and fractures.
  
  
  METHODS
  From January 2006 to April 2010, we consecutively included 343 women with EBC who were about to start adjuvant AI therapy. Participants were assessed at baseline (before AI initiation) and at 3 months, with annual assessments thereafter. Bone mineral density (BMD), spine X-ray, bone metabolism (vitamin D [25(OH)D], bone turnover markers [BTM]), arthralgia and quality of life are measured.
  
  
  RESULTS
  Mean age was 61.9 years; 197 (57.4%) had been previously treated with tamoxifen; 145 (42.3%) were taking exemestane, 187 (54.5%) letrozole, and 11 (3.2%) anastrozole. Analysis of baseline data shows only 59 women (17.7%) had normal BMD; 200 (60.1%) had osteopenia and 74 (22.2%) had osteoporosis; 39 women (11.4%) had a prevalent fracture, 293 (89.1%) had 25(OH)D insufficiency (<30 ng/ml), and 61 (18.5%) severe deficiency (<10 ng/ml). Low 25(OH)D concentrations were associated with lower BMD and 233 (67.9%) participants had some degree of arthralgia.
  
  
  CONCLUSIONS
  Low bone mass, prevalent fractures and vitamin D insufficiency were highly prevalent among candidates to adjuvant AI for EBC. Therefore, it is crucial to assess BMD, prevalent fractures and 25(OH)D concentrations before starting AI therapy and during follow-up.
authors.affiliation: Medical Oncology Department, Breast Cancer Unit, Parc de Salut Mar-Barcelona, Molecular Therapeutics and Biomarkers in Breast Cancer, Cancer Research Program, Autonomous University of Barcelona, Spain. sservitja@parcdesalutmar.cat
authors.forename: Sònia
authors.initials: S
authors.lastname: Servitja
authors.forename: Xavier
authors.initials: X
authors.lastname: Nogués
authors.forename: Daniel
authors.initials: D
authors.lastname: Prieto-Alhambra
authors.forename: María
authors.initials: M
authors.lastname: Martínez-García
authors.forename: Laia
authors.initials: L
authors.lastname: Garrigós
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Peña
authors.forename: Marta
authors.initials: M
authors.lastname: de Ramon
authors.forename: Adolfo
authors.initials: A
authors.lastname: Díez-Pérez
authors.forename: Joan
authors.initials: J
authors.lastname: Albanell
authors.forename: Ignasi
authors.initials: I
authors.lastname: Tusquets
mesh_terms: D000368:Aged; D047072:Aromatase Inhibitors / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D015519:Bone Density; D016723:Bone Remodeling / Q000187:drug effects / Q000502:physiology; D001862:Bone Resorption / Q000139:chemically induced / Q000517:prevention & control; D001842:Bone and Bones / Q000187:drug effects* / Q000378:metabolism*; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D005598:Fractures, Spontaneous / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life
chemical_list: D047072:Aromatase Inhibitors