Abstract
The use of aromatase inhibitors is frequent in adjuvant therapy of postmenopausal women with hormone-responsive breast cancer. Estrogen deprivation caused by administration of aromatase inhibitors may lead to a decrease in bone mineral density and, according to some studies, to an increased risk of fractures. LH-RH agonists can be used in premenopausal women with breast cancer, or for other indications such as endometriosis. They are more frequently prescribed for men with prostate cancer so as to carry out a chemical castration; in this setting LH-RH agonists are responsible for a rapid bone loss which is greater at the beginning of treatment, and for an increased risk of fractures. Patients being treated for cancer should receive adequate bone health monitoring. Prevention of bone adverse events observed with aromatase inhibitors in women and with LHRH agonists in men depends on detection of other fracture risk factors, bone mineral density measurement, lifestyle modifications with correction of calcium and vitamin D deficiency, and treatment, notably using bisphosphonates, when patients have past history of fracture or low bone mineral density.
Published Version
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