Evaluation of osteopenia and osteoporosis in younger breast cancer survivors compared with cancer-free women: a prospective cohort study

Cody Ramin, Betty J. May, Richard S Roden, Mikiaila M. Orellana, Brenna C. Hogan, Michelle S. McCullough, Dana Petry, Deborah Kay Armstrong, Kala Visvanathan

Research output: Contribution to journalArticle

Abstract

BACKGROUND: 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. METHODS: We 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. RESULTS: During 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. CONCLUSIONS: Younger 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.

Original languageEnglish (US)
Number of pages1
JournalBreast cancer research : BCR
Volume20
Issue number1
DOIs
StatePublished - Nov 13 2018

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Metabolic Bone Diseases
Osteoporosis
Survivors
Cohort Studies
Prospective Studies
Breast Neoplasms
Neoplasms
Bone and Bones
Aromatase Inhibitors
Incidence
Proportional Hazards Models
Estrogen Receptors
Bone Density
Hormones
Physicians
Drug Therapy

Keywords

  • Bone loss
  • Breast cancer survivors
  • Cancer-free women
  • Osteopenia
  • Osteoporosis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Evaluation of osteopenia and osteoporosis in younger breast cancer survivors compared with cancer-free women : a prospective cohort study. / Ramin, Cody; May, Betty J.; Roden, Richard S; Orellana, Mikiaila M.; Hogan, Brenna C.; McCullough, Michelle S.; Petry, Dana; Armstrong, Deborah Kay; Visvanathan, Kala.

In: Breast cancer research : BCR, Vol. 20, No. 1, 13.11.2018.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: 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. METHODS: We 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. RESULTS: During 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. CONCLUSIONS: Younger 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.",
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T1 - Evaluation of osteopenia and osteoporosis in younger breast cancer survivors compared with cancer-free women

T2 - a prospective cohort study

AU - Ramin, Cody

AU - May, Betty J.

AU - Roden, Richard S

AU - Orellana, Mikiaila M.

AU - Hogan, Brenna C.

AU - McCullough, Michelle S.

AU - Petry, Dana

AU - Armstrong, Deborah Kay

AU - Visvanathan, Kala

PY - 2018/11/13

Y1 - 2018/11/13

N2 - BACKGROUND: 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. METHODS: We 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. RESULTS: During 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. CONCLUSIONS: Younger 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.

AB - BACKGROUND: 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. METHODS: We 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. RESULTS: During 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. CONCLUSIONS: Younger 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.

KW - Bone loss

KW - Breast cancer survivors

KW - Cancer-free women

KW - Osteopenia

KW - Osteoporosis

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