TY - JOUR
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 B.S.
AU - Orellana, Mikiaila M.
AU - Hogan, Brenna C.
AU - McCullough, Michelle S.
AU - Petry, Dana
AU - Armstrong, Deborah K.
AU - Visvanathan, Kala
N1 - Funding Information:
This research was supported in part by the Breast Cancer Research Foundation, the Avon Breast Cancer Research Program Network, and grants from the National Cancer Institute at the National Institutes of Health (T32-CA009314, P50CA098252, and P30CA06973).
Funding Information:
The authors thank the State of Maryland, the Maryland Cigarette Restitution Fund, and the National Program of Cancer Registries of the Centers for Disease Control and Prevention for the funds that helped support the collection and availability of the cancer registry data. The Maryland Cancer Registry contributed cancer incidence data to this project. Center for Cancer Prevention and Control, Department of Health and Mental Hygiene, 201 West Preston Street, Room 400, Baltimore, MD 21201; https://phpa.health.maryland.gov/cancer/Pages/ mcr_home.aspx, 410-767-4055. The authors also thank the participants and staff of the BOSS cohort study.
Publisher Copyright:
© 2018 The Author(s).
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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U2 - 10.1186/s13058-018-1061-4
DO - 10.1186/s13058-018-1061-4
M3 - Article
C2 - 30424783
AN - SCOPUS:85056510364
SN - 1465-5411
VL - 20
JO - Breast Cancer Research
JF - Breast Cancer Research
IS - 1
M1 - 134
ER -