Management of osteoporosis after gynecological cancer

Abstract

Breast Cancer remains the most frequent cancer in women. Women with breast cancer now expect to live longer than before and the prevention of morbidity induced by cancer treatment is a concern. In ER-positive Breast Cancer, the goal of Adjuvant treatment is to inhibit the impact of estrogen on the breast. Aromatase inhibitors are associated with increased bone loss. Critical is the role of a careful baseline evaluation of the risk of fracture in all postmenopausal women with breast cancer and especially in the cases treated with aromatase inhibitors. Pharmacologic intervention is recommended to those with a T-score <-2 or with 2 or more clinical risk factors for fracture with adequate calcium and vitamin D supplementation. There is a consensus about Bisphosphonates and bone loss in breast cancer patients. Osteoporotic treatment should be continued at least until the adjuvant breast cancer treatment is completed or even longer in women with high risk of fracture.