Managing Bone Health in Breast Cancer |
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| Institution: | 1. Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China;2. The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China;1. Department of Endocrinology, Mayo Clinic, Jacksonville, Florida;2. Department of Endocrinology, Stanford University, Stanford, California;3. Department of Otorhinolaryngology, Ankara University, Ankara, Turkey;4. Division of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, Florida;5. Department of Otorhinolaryngology and Audiology, Mayo Clinic, Jacksonville, Florida;1. Endocrinology and Metabolism Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México;2. Clinical Epidemiology Unit, Hospital Infantil Federico Gómez, Mexico City, México;3. Clinical Epidemiology Unit, UMAE, Hospital de Especialidades Centro Medico Siglo XXI, IMSS, Mexico City, México;4. Metabolic Diseases Research Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México;1. Department of Medicine, Division of Cardiology, University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio;2. Department of Medicine, Diabetes & Obesity Center, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio;1. Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan;2. Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland |
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| Abstract: | ObjectiveOsteoporosis is a common condition that can be caused or exacerbated by estrogen deficiency.MethodsThis narrative review will discuss optimizing bone health in the setting of adjuvant endocrine treatments for hormone receptor–positive breast cancer and the current use of antiresorptive agents as adjuvant therapy and as bone modifying agents.ResultsAdjuvant endocrine treatments for hormone receptor–positive breast cancer (tamoxifen and aromatase inhibitors) affect bone health. The exact effect depends on the agent used and the menopausal state of the woman. Antiresorptive medications for osteoporosis, bisphosphonates and denosumab, lower the risk of bone loss from aromatase inhibitors. Use of bisphosphonates as adjuvant treatment in breast cancer, regardless of hormone receptor status, is increasing because of benefits seen to cancer relapse and survival.ConclusionOptimizing bone health in women with breast cancer during and after cancer treatment is informed by an understanding of breast cancer treatment and its skeletal effect. |
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| Keywords: | breast cancer osteoporosis aromatase inhibitor bisphosphonate denosumab estrogen |
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