The influence of chemotherapy on bone mineral density, quantitative ultrasonometry and bone turnover in pre-menopausal women with breast cancer

Abstract

Introduction The effects of doxorubicin/cyclophosphamide (A/C; 6 cycles) chemotherapy on bone mineral density (BMD), quantitative ultrasonography (QUS) and bone turnover markers in pre-menopausal women with oestrogen receptor-negative breast cancer (BC) were compared with age-matched controls. Methods Among 106 women (BC = 53, controls = 53), BMD (spine and hip), QUS (calcaneus and phalanges) and bone marker levels were measured at baseline, 6 and 12 months. Correlations between parameters were determined by Spearman’s rho. Results All BC patients became amenorrhoeic after chemotherapy and remained so for the duration of treatment. BC patients had significant bone loss at all sites ( P ⩽ .005) and significant increases in bone turnover ( P ⩽ .05). There were significant correlations between BMD, QUS and bone markers ( P ⩽ .05). Conclusions Results confirm A/C’s deleterious influence on bone health in pre-menopausal women with BC and established QUS’s utility for monitoring bone effects. Large-scale longitudinal studies are needed to further understand and prevent bone changes following chemotherapy.