title: Bone remodeling and regulating biomarkers in women at the time of breast cancer diagnosis.
abstract: The majority of breast cancer patients receive endocrine therapy, including aromatase inhibitors known to cause increased bone resorption. Bone-related biomarkers at the time of breast cancer diagnosis may predict future risk of osteoporosis and fracture after endocrine therapy.
  
  
  
  In a large population of 2,401 female breast cancer patients who later underwent endocrine therapy, we measured two bone remodeling biomarkers, TRAP5b and BAP, and two bone regulating biomarkers, RANKL and OPG, in serum samples collected at the time of breast cancer diagnosis. We analyzed these biomarkers and their ratios with patients' demographic, lifestyle, clinical tumor characteristics, as well as bone health history.
  
  
  
  The presence of bone metastases, prior bisphosphonate (BP) treatment, and blood collection after chemotherapy had a significant impact on biomarker levels. After excluding these cases and controlling for blood collection time, several factors, including age, race/ethnicity, body mass index, physical activity, alcohol consumption, smoking, and hormonal replacement therapy, were significantly associated with bone biomarkers, while vitamin D or calcium supplements and tumor characteristics were not. When prior BP users were included in, recent history of osteoporosis and fracture was also associated.
  
  
  
  Our findings support further investigation of these biomarkers with bone health outcomes after endocrine therapy initiation in women with breast cancer.
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, 14263, USA. song.yao@roswellpark.org.
authors.forename: Song
authors.initials: S
authors.lastname: Yao
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, 14263, USA.|Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA.
authors.forename: Yali
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, 14263, USA.
authors.forename: Li
authors.initials: L
authors.lastname: Tang
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors.forename: Janise M
authors.initials: JM
authors.lastname: Roh
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors.forename: Cecile A
authors.initials: CA
authors.lastname: Laurent
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, 14263, USA.
authors.forename: Chi-Chen
authors.initials: CC
authors.lastname: Hong
authors.affiliation: Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Hahn
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors.forename: Joan C
authors.initials: JC
authors.lastname: Lo
authors.affiliation: Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, 14263, USA.
authors.forename: Christine B
authors.initials: CB
authors.lastname: Ambrosone
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Kushi
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Kwan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D014408:Biomarkers, Tumor; D015519:Bone Density; D001847:Bone Diseases / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology; D001859:Bone Neoplasms / Q000378:metabolism / Q000556:secondary; D016723:Bone Remodeling; D001943:Breast Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D015444:Exercise; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D017698:Postmenopause; D017697:Premenopause; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor
keywords: Aromatase inhibitor; Biomarker; Bone; Breast cancer; Tamoxifen