title: Guidelines for diagnostics and treatment of aromatase inhibitor-induced bone loss in women with breast cancer: a consensus of Lithuanian medical oncologists, radiation oncologists, endocrinologists, and family medicine physicians.
abstract: The aim of this article is to inform about cancer treatment-induced bone loss, to identify patients at risk and those that can benefit from bone targeted treatment as well as highlight the importance of the multidisciplinary approach in the bone health in cancer care. Patients with breast cancer treated or intended to be treated with aromatase inhibitors belong to a high-risk group because their fracture risk increases up to 30% due to a significant decrease in bone mineral density within 6-12 months after the start of hormonal treatment. To evaluate bone status and predict risk for fractures, lateral thoracic and lumbar spine X-ray imaging, bone mineral density measurement by dual energy X-ray absorptiometry at the lumbar spine L1-L4 vertebrae and/or hip and fracture risk factors assessment are mandatory tests prior to hormonal treatment. Morbidity and mortality associated with bone loss can be prevented with appropriate screening, lifestyle interventions, and therapy. Algorithm for the management of bone health in breast cancer patients was established in Lithuania to screen patients with increased risk for bone loss and to provide adequate specific osteoporosis treatment.
authors.affiliation: Institute of Oncology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania. Electronic address: elona.juozaityte@kaunoklinikos.lt.
authors.forename: Elona
authors.initials: E
authors.lastname: Juozaitytė
authors.affiliation: Radiotherapy and Drug Therapy Centre, National Cancer Institute, Vilnius University, Vilnius, Lithuania.
authors.forename: Eduardas
authors.initials: E
authors.lastname: Aleknavičius
authors.affiliation: Institute of Oncology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Rasa
authors.initials: R
authors.lastname: Jančiauskienė
authors.affiliation: Department of Oncology, Klaipėda University Hospital, Klaipėda, Lithuania.
authors.forename: Alvydas
authors.initials: A
authors.lastname: Cesas
authors.affiliation: Radiotherapy and Drug Therapy Centre, National Cancer Institute, Vilnius University, Vilnius, Lithuania.
authors.forename: Teresė
authors.initials: T
authors.lastname: Pipirienė-Želvienė
authors.affiliation: Institute of Oncology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Sigita
authors.initials: S
authors.lastname: Liutkauskienė
authors.affiliation: Department of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Aurelija
authors.initials: A
authors.lastname: Krasauskienė
authors.affiliation: Clinic of Internal Diseases, Family Medicine, Gerontology and Oncology, Vilnius University, Vilnius, Lithuania.
authors.forename: Lina
authors.initials: L
authors.lastname: Vencevičienė
mesh_terms: D047072:Aromatase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects; D001859:Bone Neoplasms / Q000175:diagnosis / Q000556:secondary; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008097:Lithuania; D010024:Osteoporosis / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy*; D017410:Practice Guidelines as Topic
chemical_list: D047072:Aromatase Inhibitors
keywords: Aromatase inhibitors; Bone mineral density; Breast cancer; Osteoporotic fracture; Specific osteoporosis treatment