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Breast cancer survivors are at an increased risk for osteoporotic fractures not explained by lower BMD: a retrospective analysis

BACKGROUND: An association between higher bone mineral density (BMD) and the diagnosis of breast cancer (BC) has been reported. Data on the risk of osteoporotic fractures in women with BC are conflicting. AIMS: The objective of this study was to assess fracture risk adjusted for BMD in women with an...

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Autores principales: Fraenkel, Merav, Geffen, David B, Novack, Victor, Shafat, Tali, Mizrakli, Yuval, Ariad, Samuell, Koretz, Michael, Norton, Larry, Siris, Ethel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5515201/
https://www.ncbi.nlm.nih.gov/pubmed/28721367
http://dx.doi.org/10.1038/npjbcancer.2015.10
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author Fraenkel, Merav
Geffen, David B
Novack, Victor
Shafat, Tali
Mizrakli, Yuval
Ariad, Samuell
Koretz, Michael
Norton, Larry
Siris, Ethel
author_facet Fraenkel, Merav
Geffen, David B
Novack, Victor
Shafat, Tali
Mizrakli, Yuval
Ariad, Samuell
Koretz, Michael
Norton, Larry
Siris, Ethel
author_sort Fraenkel, Merav
collection PubMed
description BACKGROUND: An association between higher bone mineral density (BMD) and the diagnosis of breast cancer (BC) has been reported. Data on the risk of osteoporotic fractures in women with BC are conflicting. AIMS: The objective of this study was to assess fracture risk adjusted for BMD in women with and without BC, and to assess whether fracture risk in BC patients is attributed to BMD or BC characteristics. METHODS: Using electronic medical records of patients who underwent dual energy X-ray absorptiometry BMD studies at Soroka University Medical Center between February 2003 and March 2011, we identified women with subsequent diagnosis of osteoporotic fractures. BC status, demographic, health characteristics, BMD, and other laboratory findings were assessed. In BC patients data on grade, stage, and treatment were collected. Primary outcome was osteoporotic fracture, analyzed by Cox proportional hazards regression models. RESULTS: During a median follow-up of 4.9 years in 17,110 women with BMD testing (658 BC patients), 1,193 women experienced an osteoporotic fracture (62 in BC and 1,131 in no-BC groups). In multivariate analysis adjusted for age, body mass index (BMI) and BMD, hazard ratio (HR) for any osteoporotic fracture in women with BC was 1.34 (P=0.026). BMD was similar among women with and without BC who fractured. BC patients who experienced an osteoporotic fracture had a trend for less-advanced BC, lower rates of chemotherapy treatment, and higher rates of tamoxifen treatment. CONCLUSIONS: BC survivors are at increased risk of an osteoporotic fracture, which is not explained by worse BMD. Chemotherapy or aromatase inhibitors did not contribute substantially to fracture risk among our BC survivors.
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spelling pubmed-55152012017-07-18 Breast cancer survivors are at an increased risk for osteoporotic fractures not explained by lower BMD: a retrospective analysis Fraenkel, Merav Geffen, David B Novack, Victor Shafat, Tali Mizrakli, Yuval Ariad, Samuell Koretz, Michael Norton, Larry Siris, Ethel NPJ Breast Cancer Article BACKGROUND: An association between higher bone mineral density (BMD) and the diagnosis of breast cancer (BC) has been reported. Data on the risk of osteoporotic fractures in women with BC are conflicting. AIMS: The objective of this study was to assess fracture risk adjusted for BMD in women with and without BC, and to assess whether fracture risk in BC patients is attributed to BMD or BC characteristics. METHODS: Using electronic medical records of patients who underwent dual energy X-ray absorptiometry BMD studies at Soroka University Medical Center between February 2003 and March 2011, we identified women with subsequent diagnosis of osteoporotic fractures. BC status, demographic, health characteristics, BMD, and other laboratory findings were assessed. In BC patients data on grade, stage, and treatment were collected. Primary outcome was osteoporotic fracture, analyzed by Cox proportional hazards regression models. RESULTS: During a median follow-up of 4.9 years in 17,110 women with BMD testing (658 BC patients), 1,193 women experienced an osteoporotic fracture (62 in BC and 1,131 in no-BC groups). In multivariate analysis adjusted for age, body mass index (BMI) and BMD, hazard ratio (HR) for any osteoporotic fracture in women with BC was 1.34 (P=0.026). BMD was similar among women with and without BC who fractured. BC patients who experienced an osteoporotic fracture had a trend for less-advanced BC, lower rates of chemotherapy treatment, and higher rates of tamoxifen treatment. CONCLUSIONS: BC survivors are at increased risk of an osteoporotic fracture, which is not explained by worse BMD. Chemotherapy or aromatase inhibitors did not contribute substantially to fracture risk among our BC survivors. Nature Publishing Group 2015-07-22 /pmc/articles/PMC5515201/ /pubmed/28721367 http://dx.doi.org/10.1038/npjbcancer.2015.10 Text en Copyright © 2015 Breast Cancer Research Foundation/Macmillan Publishers Limited http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
spellingShingle Article
Fraenkel, Merav
Geffen, David B
Novack, Victor
Shafat, Tali
Mizrakli, Yuval
Ariad, Samuell
Koretz, Michael
Norton, Larry
Siris, Ethel
Breast cancer survivors are at an increased risk for osteoporotic fractures not explained by lower BMD: a retrospective analysis
title Breast cancer survivors are at an increased risk for osteoporotic fractures not explained by lower BMD: a retrospective analysis
title_full Breast cancer survivors are at an increased risk for osteoporotic fractures not explained by lower BMD: a retrospective analysis
title_fullStr Breast cancer survivors are at an increased risk for osteoporotic fractures not explained by lower BMD: a retrospective analysis
title_full_unstemmed Breast cancer survivors are at an increased risk for osteoporotic fractures not explained by lower BMD: a retrospective analysis
title_short Breast cancer survivors are at an increased risk for osteoporotic fractures not explained by lower BMD: a retrospective analysis
title_sort breast cancer survivors are at an increased risk for osteoporotic fractures not explained by lower bmd: a retrospective analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5515201/
https://www.ncbi.nlm.nih.gov/pubmed/28721367
http://dx.doi.org/10.1038/npjbcancer.2015.10
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