Abstract
BackgroundOsteoporosis, an indicator of significant bone loss, has been consistently reported among older breast cancer survivors. Data are limited on the incidence of osteopenia, an earlier indicator of bone loss, and osteoporosis in younger breast cancer survivors compared with cancer-free women.MethodsWe prospectively examined bone loss in 211 breast cancer survivors (mean age at breast cancer diagnosis = 47 years) compared with 567 cancer-free women in the same cohort with familial risk for breast cancer. Multivariable-adjusted Cox proportional hazards models were used to estimate HRs and 95% CIs of osteopenia and/or osteoporosis incidence based on physician diagnosis.ResultsDuring a mean follow-up of 5.8 years, 66% of breast cancer survivors and 53% of cancer-free women reported having a bone density examination, and 112 incident cases of osteopenia and/or osteoporosis were identified. Breast cancer survivors had a 68% higher risk of osteopenia and osteoporosis compared to cancer-free women (HR = 1.68, 95% CI = 1.12–2.50). The association was stronger among recent survivors after only 2 years of follow-up (HR = 2.74, 95% CI = 1.37–5.47). A higher risk of osteopenia and osteoporosis was also observed among survivors aged ≤ 50 years, estrogen receptor-positive tumors, and those treated with aromatase inhibitors alone or chemotherapy plus any hormone therapy relative to cancer-free women.ConclusionsYounger breast cancer survivors are at higher risk for osteopenia and osteoporosis compared to cancer-free women. Studies are needed to determine effective approaches to minimize bone loss in this population.
Highlights
Osteopenia and osteoporosis, both systemic skeletal conditions associated with varying degrees of bone loss, are prevalent among postmenopausal breast cancer survivors, with prior reports of up to 80% experiencing loss in bone density [1]
To identify whether bone loss differed by subgroups of breast cancer survivors, we examined the risk of osteopenia and osteoporosis in survivors stratified by age at diagnosis, menopausal status at diagnosis, Estrogen receptor (ER) tumor status, and breast cancer treatment relative to cancer-free women
We were unable to Results Age and age-adjusted baseline characteristics were compared in breast cancer survivors and cancer-free women (Table 1)
Summary
Osteopenia and osteoporosis, both systemic skeletal conditions associated with varying degrees of bone loss, are prevalent among postmenopausal breast cancer survivors, with prior reports of up to 80% experiencing loss in bone density [1]. Ramin et al Breast Cancer Research (2018) 20:134 it is estimated that 1 in 2 women will be at risk for an osteoporosis-related fracture during their lifetime [2, 6]. By comparing cancer survivors with cancer-free individuals, these risk factors can be differentiated. Osteoporosis, an indicator of significant bone loss, has been consistently reported among older breast cancer survivors. Data are limited on the incidence of osteopenia, an earlier indicator of bone loss, and osteoporosis in younger breast cancer survivors compared with cancer-free women
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