Abstract
Aim: To determine the levels of Wnt inhibitors in patients treated with aromatase inhibitors (AIs) prior to therapy and to investigate their association with bone mineral density (BMD) and lifestyle parameters. Methods: 137 breast cancer patients were divided into a group treated with 1 mg of anastrozole and a group w/o anastrozole therapy. Serum concentrations of sclerostin and dickkopf1 (DKK1) were measured by ELISA. BMD was measured by dual-energy X-ray absorptiometry (DXA). Lifestyle factors were investigated by a self-reported questionnaire. Results: Sclerostin was significantly higher in the AI-treated group (31.8 pmol/L vs. 24.1 pmol/L; p < 0.001), whereas DKK1 was significantly lower in the AI-treated group (24.3 pmol/L vs. 26.02 pmol/L; p < 0.001). Total hip and femoral neck BMD were significantly lower in the AI-treated group. Conclusion: AI treatment was associated with increased levels of sclerostin and decreased levels of DKK1.
Highlights
The treatment of breast cancer (BC) is multidisciplinary and includes surgery, radiation, chemotherapy and adjuvant endocrine therapy in cases of hormone receptor-positive BC
The study included 137 postmenopausal women diagnosed with hormone receptor (ER) positive BC. 84 postmenopausal patients on therapy with aromatase inhibitors (AIs) (61.3%) had a mean age of 64 years, and a group of 53 patients (38.7%) w/o AIs therapy had mean age of 59.5 years (IQR 55–67 years)
There were no significant differences between the two groups regarding lifestyle and eating habits such as alcohol consumption, calcium intake, consumption of dairy products or previous hip fracture
Summary
The treatment of breast cancer (BC) is multidisciplinary and includes surgery, radiation, chemotherapy and adjuvant endocrine therapy in cases of hormone receptor-positive BC. Two-thirds of all BCs are estrogen receptor (ER)-positive and, are candidates for either selective ER modulators (SERMs) or third generation aromatase inhibitors (AIs). According to the recent study aromatase inhibitor-associated bone loss (AIBL) occurs at a rate at least 2-fold higher than bone loss seen in healthy, age-matched postmenopausal women, resulting in a significantly higher fracture incidence. It is concluded that adjuvant AI therapy depletes residual estrogen and is associated with rapid bone loss, and the increased fracture risk is distinctly different from that observed in postmenopausal osteoporosis [7]. Similar findings in the ATAC (Arimidex, Tamoxifen, alone or in combination) bone subprotocol confirmed that adjuvant anastrozole therapy for postmenopausal women with early breast cancer led to accelerated bone loss [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
