Antineoplastic treatment effect on bone mineral density in Mexican breast cancer patients.
Breast cancer is the most deadly malignancy in Mexican women. Although treatment has improved, it may significantly affect bone mineral status in those who receive it. The aim of this study was to assess the impact of cancer treatment on bone mineral density (BMD) and bone mineral content (BMC), in patients with breast cancer and explore the interaction of menopausal status and clinical stage with cancer treatment on such changes.



A quasi-experimental design was applied with measurements before and after a chemotherapy treatment in 40 patients with primary diagnosis of invasive breast cancer. BMD and body composition measurements were taken by dual X-ray absorptiometry (DXA) and changes in these variables due to therapy were analyzed using mixed regression for repeated measurements.



Significant loss was found in femoral neck and L2-L4 BMD (p < 0.001). Patients diagnosed with osteopenia or osteoporosis received calcium + vitamin D supplementation (600 mg/200 IU day). It showed a protective effect in the decrease of femoral neck BMD and total BMC. BMD loss in both femoral neck and L2-L4 BMD was higher in premenopausal women: 0.023 g/cm2in femoral neck and 0.063 g/cm2in L2-L4 (p < 0.001), while in postmenopausal women BMD loss was 0.015 g/cm2in femoral neck and 0.035 g/cm2in L2-L4 (p = 0.021 and p = 0.001 respectively). Change in lumbar spine BMD was prominent in premenopausal women with advanced clinical stage (IIB, IIIA, IIIB): 0.066 g/cm2(p = 0.003).



The antineoplastic breast cancer treatment with chemotherapy had a negative impact on BMD, in premenopausal women overall, although a differential effect was found according to clinical stage and calcium supplementation status.
Centro de Investigación en Alimentación y Desarrollo (CIAD), Coordinación de Nutrición, Carretera a La Victoria km 0.6, C.P. 83304, Hermosillo, Sonora, Mexico.
Karina
K
Monroy-Cisneros
Centro de Investigación en Alimentación y Desarrollo (CIAD), Coordinación de Nutrición, Carretera a La Victoria km 0.6, C.P. 83304, Hermosillo, Sonora, Mexico.
Julián
J
Esparza-Romero
Departamento de Ciencias Químico-Biológicas, Coordinación de Ciencias Nutricionales, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Hermosillo, Sonora, Mexico.
Mauro E
ME
Valencia
Centro Estatal de Oncología (CEO), Reforma final y Paseo Río San Miguel, C.P. 83280, Hermosillo, Sonora, Mexico.
Alfonso G
AG
Guevara-Torres
Centro de Investigación en Alimentación y Desarrollo (CIAD), Coordinación de Nutrición, Carretera a La Victoria km 0.6, C.P. 83304, Hermosillo, Sonora, Mexico.
Rosa O
RO
Méndez-Estrada
Centro de Investigación en Alimentación y Desarrollo (CIAD), Coordinación de Nutrición, Carretera a La Victoria km 0.6, C.P. 83304, Hermosillo, Sonora, Mexico.
Iván
I
Anduro-Corona
Centro de Investigación en Alimentación y Desarrollo (CIAD), Coordinación de Nutrición, Carretera a La Victoria km 0.6, C.P. 83304, Hermosillo, Sonora, Mexico. hastiazaran@ciad.mx.
Humberto
H
Astiazarán-García
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D014408:Biomarkers, Tumor; D015519:Bone Density; D001847:Bone Diseases / Q000209:etiology* / Q000473:pathology*; D001943:Breast Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D005260:Female; D006801:Humans; D008593:Menopause; D008800:Mexico; D008875:Middle Aged; D009367:Neoplasm Staging; D012307:Risk Factors
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor
Bone resorption; Breast neoplasm; Calcium; Chemotherapy; Menopause