title: Effects of Exemestane and Tamoxifen treatment on bone texture analysis assessed by TBS in comparison with bone mineral density assessed by DXA in women with breast cancer.
abstract: We performed an analysis of a substudy of the randomized Tamoxifen Exemestane Adjuvant Multinational trial to determine the effects of exemestane (EXE) and tamoxifen (TAM) adjuvant treatment on bone mineral density (BMD) measured by dual-energy X-ray absorptiometry compared with the trabecular bone score, a novel grey-level texture measurement that correlates with 3-dimensional parameters of bone texture in postmenopausal women with hormone receptor-positive breast cancer for the first time. In total, 36 women were randomized to receive TAM (n = 17) or EXE (n = 19). Patients receiving TAM showed a mean increase of BMD in lumbar spine from baseline of 1.0%, 1.5%, and 1.9% and in trabecular bone score of 2.2%, 3.5%, and 3.3% at 6-, 12-, and 24-mo treatment, respectively. Conversely, patients receiving EXE showed a mean decrease from baseline in lumbar spine BMD of -2.3%, -3.6%, and -5.3% and in trabecular bone score of -0.9%, -1.7%, and -2.3% at 6-, 12-, and 24-mo treatment, respectively. Changes in trabecular bone score from baseline at spine were also significantly different between EXE and TAM: p = 0.05, 0.007, and 0.006 at 6, 12, and 24 mo, respectively. TAM induced an increase in BMD and bone texture analysis, whereas EXE resulted in decreases. The results were independent from each other.
authors.affiliation: Department of Gynecology, Gynecological Endocrinology and Oncology, Philipps University of Marburg, Marburg, Germany. Electronic address: kalder@med.uni-marburg.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Kalder
authors.affiliation: Center of Bone Diseases, Department of Bone and Joints, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Didier
authors.initials: D
authors.lastname: Hans
authors.affiliation: Department of Gynecology, Gynecological Endocrinology and Oncology, Philipps University of Marburg, Marburg, Germany.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kyvernitakis
authors.affiliation: Center of Bone Diseases, Department of Bone and Joints, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lamy
authors.affiliation: Department of Gynecology, Gynecological Endocrinology and Oncology, Philipps University of Marburg, Marburg, Germany.
authors.forename: Martina
authors.initials: M
authors.lastname: Bauer
authors.affiliation: Department of Gynecology, Gynecological Endocrinology and Oncology, Philipps University of Marburg, Marburg, Germany.
authors.forename: Peyman
authors.initials: P
authors.lastname: Hadji
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000730:Androstadienes / Q000494:pharmacology* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D008875:Middle Aged; D013499:Surface Properties / Q000187:drug effects; D013629:Tamoxifen / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D000730:Androstadienes; D000970:Antineoplastic Agents; D050071:Bone Density Conservation Agents; D013629:Tamoxifen; C056516:exemestane
keywords: Aromatase inhibitor; bone mineral density; breast cancer; tamoxifen; trabecular bone score