title: Impact of aromatase inhibitor treatment on vertebral morphology and bone mineral density in postmenopausal women with breast cancer.
abstract: OBJECTIVE
  The aim of this study was to evaluate the impact of aromatase inhibitor (AI) treatment on vertebral morphology by vertebral fracture assessment in postmenopausal women with early-stage breast cancer.
  
  
  METHODS
  A clinical cross-sectional study was conducted. A group of 156 postmenopausal women with breast cancer (mean [SD] age, 60.4 [10.1] y; mean [SD] time since menopause, 11.7 [9.2] y) was included in the study. Eighty-two women received AI treatment, whereas 74 women did not. Women underwent extensive medical history check and risk factor assessment together with vertebral morphology and bone mineral density (BMD) evaluation.
  
  
  RESULTS
  In the studied population, the prevalence of vertebral fractures identified by vertebral fracture assessment was 16.6%. Multivariate analysis showed that AI treatment was significantly associated with vertebral fractures (adjusted P < 0.04). Women receiving AI treatment had a higher prevalence of vertebral fractures than women not treated with AIs (25.6% vs. 4%). The risk of vertebral fractures in women treated with AIs was significantly higher than in non-AI-treated women (adjusted odds ratio, 4.7; P < 0.005). Vertebral fractures of the highest grade were identified at the lumbar spine. Women treated with AIs had a significantly lower BMD than women not treated with AIs (P < 0.01). Reduction of BMD was significantly associated with length of therapy, whereas there was no association between length of treatment and risk of vertebral fractures.
  
  
  CONCLUSIONS
  AI treatment severely impacts vertebral morphology. Our study demonstrates a high prevalence of asymptomatic vertebral fractures in women treated with AIs.
authors: 1Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy2Department of Endocrinology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Paola
authors: P
authors: Villa
authors: Anna P
authors: AP
authors: Lassandro
authors: Inbal D
authors: ID
authors: Amar
authors: Lorenzo
authors: L
authors: Vacca
authors: Maria C
authors: MC
authors: Moruzzi
authors: Gabriella
authors: G
authors: Ferrandina
authors: Daniela
authors: D
authors: Terribile
authors: Riccardo
authors: R
authors: Masetti
authors: Giovanni
authors: G
authors: Scambia
mesh_terms: D000368:Aged; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D058070:Asymptomatic Diseases / Q000453:epidemiology; D015519:Bone Density / Q000187:drug effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000187:drug effects*; D008875:Middle Aged; D016017:Odds Ratio; D017698:Postmenopause; D015995:Prevalence; D016103:Spinal Fractures / Q000139:chemically induced* / Q000453:epidemiology; D013997:Time Factors
chemical_list: D047072:Aromatase Inhibitors