title: ADJUVANT (HORMONAL) THERAPY AS A CAUSE OF BONE LOSS IN PATIENTS WITH BREAST CANCER (REVIEW OF LITERATURE).
abstract: Adjuvant (hormonal) therapy is the main method of treatment after surgery in hormone (estrogen and/or progesterone) positive breast cancer patients. The goal of above mentioned treatment is to reduce or block the level of estrogen and progesterone. ultiple clinical trials have revealed that hormonal therapy in breast cancer patients affect bone mineral density (BMD). Authors have analyzed data obtained from several clinical trials conducted in several countries (including Georgia). The final conclusion is that selective estrogen receptor modulators (SERMs) have negative effect on BMD in pre-menopausal women and aromatase inhibitors (anastrozole, letrozole, exemestane) are associated with significant bone loss in post-menopausal women. It is recommended to assess BMD during the adjuvant (hormonal) therapy using Dual Energy X-ray Absorptiometry (DXA). Because of significant negative impact of aromatase inhibitors on BMD, it is suggested to involve antiresorbtive treatment in parallel with hormonal therapy.
authors.affiliation: I. Javakhishvili Tbilisi State University; National Institute of Endocrinology, Tbilisi, Georgia.
authors.forename: N
authors.initials: N
authors.lastname: Khachidze
authors.affiliation: I. Javakhishvili Tbilisi State University; National Institute of Endocrinology, Tbilisi, Georgia.
authors.forename: E
authors.initials: E
authors.lastname: Giorgadze
authors.affiliation: I. Javakhishvili Tbilisi State University; National Institute of Endocrinology, Tbilisi, Georgia.
authors.forename: M
authors.initials: M
authors.lastname: Tsagareli
mesh_terms: D000077384:Anastrozole; D000730:Androstadienes / Q000009:adverse effects; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D004965:Estrogen Antagonists / Q000009:adverse effects*; D005260:Female; D006801:Humans; D000077289:Letrozole; D009570:Nitriles / Q000009:adverse effects; D010024:Osteoporosis / Q000139:chemically induced* / Q000503:physiopathology; D017698:Postmenopause; D017697:Premenopause; D020845:Selective Estrogen Receptor Modulators / Q000009:adverse effects*; D013629:Tamoxifen / Q000009:adverse effects; D014230:Triazoles / Q000009:adverse effects
chemical_list: D000730:Androstadienes; D047072:Aromatase Inhibitors; D004965:Estrogen Antagonists; D009570:Nitriles; D020845:Selective Estrogen Receptor Modulators; D014230:Triazoles; D013629:Tamoxifen; D000077384:Anastrozole; D000077289:Letrozole; C056516:exemestane