title: Screening for osteoporosis after breast cancer: for whom, why and when.
abstract: Osteoporosis and breast cancer are common diseases in postmenopausal women. Bone and the breast are both estrogenic dependent tissues and different surrogate markers for osteoporosis are opposite of those for the risk of breast cancer. In particular, numerous studies have reported a positive relationship between high bone mineral density (BMD) and a greater risk of breast cancer. On the other hand, most treatments in early breast cancer women including ovarian suppression treatments (chemotherapy, surgery or GnRH agonists) and aromatase inhibitor (AI) therapy induce a profound and rapid suppression of estrogen levels thereby increasing the rate of bone loss. Nevertheless, their impact on the risk of fracture is still questionable, especially in postmenopausal women with no osteoporosis at baseline. The purpose of this minireview is to examine the relationship between breast cancer and the risk of fracture and to discuss a screening strategy for osteoporosis after breast cancer.
authors.affiliation: Menopause and Metabolic Bone Disease Unit Hôpital Paule de Viguier CHU Toulouse 330 avenue de Grande-Bretagne TSA 70034 31059 Toulouse cedex France. Electronic address: tremollieres.fr@chu-toulouse.fr.
authors.forename: Florence A
authors.initials: FA
authors.lastname: Trémollieres
mesh_terms: D015502:Absorptiometry, Photon; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy*; D000069448:Denosumab / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008403:Mass Screening; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D058866:Osteoporotic Fractures / Q000517:prevention & control*; D018579:Patient Selection; D017698:Postmenopause; D017697:Premenopause; D018570:Risk Assessment; D012307:Risk Factors; D013629:Tamoxifen / Q000627:therapeutic use
chemical_list: D047072:Aromatase Inhibitors; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D004965:Estrogen Antagonists; D013629:Tamoxifen; D000069448:Denosumab
keywords: Aromatase inhibitors; Bisphosphonates; Breast cancer; Denosumab; Fractures; Osteoporosis; Screening