title: Bone health history in breast cancer patients on aromatase inhibitors.
abstract: A cross-sectional study was performed to assess bone health history among aromatase inhibitor (AI) users before breast cancer (BC) diagnosis, which may impact fracture risk after AI therapy and choice of initial hormonal therapy. A total of 2,157 invasive BC patients initially treated with an AI were identified from a prospective cohort study at Kaiser Permanente Northern California (KPNC). Data on demographic and lifestyle factors were obtained from in-person interviews, and bone health history and clinical data from KPNC clinical databases. The prevalence of osteoporosis and fractures in postmenopausal AI users was assessed, compared with 325 postmenopausal TAM users. The associations of bone health history with demographic and lifestyle factors in AI users were also examined. Among all initial AI users, 11.2% had a prior history of osteoporosis, 16.3% had a prior history of any fracture, and 4.6% had a prior history of major fracture. Postmenopausal women who were taking TAM as their initial hormonal therapy had significantly higher prevalence of prior osteoporosis than postmenopausal AI users (21.5% vs. 11.8%, p<0.0001). Among initial AI users, the associations of history of osteoporosis and fracture in BC patients with demographic and lifestyle factors were, in general, consistent with those known in healthy older women. This study is one of the first to characterize AI users and risk factors for bone morbidity before BC diagnosis. In the future, this study will examine lifestyle, molecular, and genetic risk factors for AI-induced fractures.
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America.
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Kwan
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America.
authors.forename: Joan C
authors.initials: JC
authors.lastname: Lo
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York, United States of America.
authors.forename: Li
authors.initials: L
authors.lastname: Tang
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America.
authors.forename: Cecile A
authors.initials: CA
authors.lastname: Laurent
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America.
authors.forename: Janise M
authors.initials: JM
authors.lastname: Roh
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America.
authors.forename: Malini
authors.initials: M
authors.lastname: Chandra
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York, United States of America.
authors.forename: Theresa E
authors.initials: TE
authors.lastname: Hahn
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York, United States of America.
authors.forename: Chi-Chen
authors.initials: CC
authors.lastname: Hong
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York, United States of America.
authors.forename: Lara
authors.initials: L
authors.lastname: Sucheston-Campbell
authors.affiliation: Department of Medicine and the Herbert Irving Comprehensive Cancer Center, Columbia University, New York, New York, United States of America.
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America.
authors.forename: Charles P
authors.initials: CP
authors.lastname: Quesenberry
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York, United States of America.
authors.forename: Christine B
authors.initials: CB
authors.lastname: Ambrosone
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Kushi
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York, United States of America.
authors.forename: Song
authors.initials: S
authors.lastname: Yao
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology*
chemical_list: D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors