Cancer therapy associated bone loss: Implications for hip fractures in mid-life women with breast cancer

Beatrice J. Edwards, Dennis W. Raisch, Veena Shankaran, June M. McKoy, William Gradishar, Andrew D. Bunta, Athena T. Samaras, Simone N. Boyle, Charles L. Bennett, Dennis P. West, Theresa Guise

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Purpose: Aromatase inhibitors (AIs) have been recently associated with hip fractures. We present a case series of breast cancer survivors and a systematic review of bone health care in breast cancer. Experimental Design: We completed clinical assessments and bone density testing (BMD) of hip fractures from January 2005 to December 2008. Prefracture and 12-month functional status was obtained. Systematic review included case reports and review of MEDLINE, PubMed, EMBASE, and Food and Drug Administration Adverse Event Reporting System (FDA AERS) from January 1998 to December 2008 (search terms: breast cancer, bone loss, osteopenia, osteoporosis, malignancy, cancer treatment, menopause, adriamycin, cytoxan, tamoxifen, and AIs). Results: Median age was 53.5 years; five women had osteopenia, one osteoporosis. Five cases were ER (+), and received surgery, XRT chemotherapy, and anastrozole. Functional decline was noted at 12 months, with difficulty in performing heavy housekeeping, climbing stairs, and shopping. The FDA AERS database included 228 cases of fractures associated with breast cancer therapy; 77/228 (29.4%) were hip or femur fractures. Among mid-life women under the age of 64 years there were 78 fractures; 15/228 (19%) were hip and femur fractures. AIs were the most common drug class associated with fractures (n = 149, 65%). Conclusions: Cancer treatment induced bone loss results in hip fractures among mid-life women with breast cancer. Hip fractures occur at younger ages and higher BMD than expected for patients in this age group without breast cancer. Hip fractures result in considerable functional decline. Greater awareness of this adverse drug effect is needed.

Original languageEnglish
Pages (from-to)560-568
Number of pages9
JournalClinical Cancer Research
Volume17
Issue number3
DOIs
StatePublished - Feb 1 2011

Fingerprint

Second Primary Neoplasms
Hip Fractures
Breast Neoplasms
Bone and Bones
Aromatase Inhibitors
Metabolic Bone Diseases
United States Food and Drug Administration
Femur
Osteoporosis
Housekeeping
Bone Neoplasms
Neoplasms
Tamoxifen
Menopause
PubMed
MEDLINE
Pharmaceutical Preparations
Bone Density
Doxorubicin
Cyclophosphamide

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Cancer therapy associated bone loss : Implications for hip fractures in mid-life women with breast cancer. / Edwards, Beatrice J.; Raisch, Dennis W.; Shankaran, Veena; McKoy, June M.; Gradishar, William; Bunta, Andrew D.; Samaras, Athena T.; Boyle, Simone N.; Bennett, Charles L.; West, Dennis P.; Guise, Theresa.

In: Clinical Cancer Research, Vol. 17, No. 3, 01.02.2011, p. 560-568.

Research output: Contribution to journalArticle

Edwards, BJ, Raisch, DW, Shankaran, V, McKoy, JM, Gradishar, W, Bunta, AD, Samaras, AT, Boyle, SN, Bennett, CL, West, DP & Guise, T 2011, 'Cancer therapy associated bone loss: Implications for hip fractures in mid-life women with breast cancer', Clinical Cancer Research, vol. 17, no. 3, pp. 560-568. https://doi.org/10.1158/1078-0432.CCR-10-1595
Edwards, Beatrice J. ; Raisch, Dennis W. ; Shankaran, Veena ; McKoy, June M. ; Gradishar, William ; Bunta, Andrew D. ; Samaras, Athena T. ; Boyle, Simone N. ; Bennett, Charles L. ; West, Dennis P. ; Guise, Theresa. / Cancer therapy associated bone loss : Implications for hip fractures in mid-life women with breast cancer. In: Clinical Cancer Research. 2011 ; Vol. 17, No. 3. pp. 560-568.
@article{615b7abf09a9427cadb98dd75a23accf,
title = "Cancer therapy associated bone loss: Implications for hip fractures in mid-life women with breast cancer",
abstract = "Purpose: Aromatase inhibitors (AIs) have been recently associated with hip fractures. We present a case series of breast cancer survivors and a systematic review of bone health care in breast cancer. Experimental Design: We completed clinical assessments and bone density testing (BMD) of hip fractures from January 2005 to December 2008. Prefracture and 12-month functional status was obtained. Systematic review included case reports and review of MEDLINE, PubMed, EMBASE, and Food and Drug Administration Adverse Event Reporting System (FDA AERS) from January 1998 to December 2008 (search terms: breast cancer, bone loss, osteopenia, osteoporosis, malignancy, cancer treatment, menopause, adriamycin, cytoxan, tamoxifen, and AIs). Results: Median age was 53.5 years; five women had osteopenia, one osteoporosis. Five cases were ER (+), and received surgery, XRT chemotherapy, and anastrozole. Functional decline was noted at 12 months, with difficulty in performing heavy housekeeping, climbing stairs, and shopping. The FDA AERS database included 228 cases of fractures associated with breast cancer therapy; 77/228 (29.4{\%}) were hip or femur fractures. Among mid-life women under the age of 64 years there were 78 fractures; 15/228 (19{\%}) were hip and femur fractures. AIs were the most common drug class associated with fractures (n = 149, 65{\%}). Conclusions: Cancer treatment induced bone loss results in hip fractures among mid-life women with breast cancer. Hip fractures occur at younger ages and higher BMD than expected for patients in this age group without breast cancer. Hip fractures result in considerable functional decline. Greater awareness of this adverse drug effect is needed.",
author = "Edwards, {Beatrice J.} and Raisch, {Dennis W.} and Veena Shankaran and McKoy, {June M.} and William Gradishar and Bunta, {Andrew D.} and Samaras, {Athena T.} and Boyle, {Simone N.} and Bennett, {Charles L.} and West, {Dennis P.} and Theresa Guise",
year = "2011",
month = "2",
day = "1",
doi = "10.1158/1078-0432.CCR-10-1595",
language = "English",
volume = "17",
pages = "560--568",
journal = "Clinical Cancer Research",
issn = "1078-0432",
publisher = "American Association for Cancer Research Inc.",
number = "3",

}

TY - JOUR

T1 - Cancer therapy associated bone loss

T2 - Implications for hip fractures in mid-life women with breast cancer

AU - Edwards, Beatrice J.

AU - Raisch, Dennis W.

AU - Shankaran, Veena

AU - McKoy, June M.

AU - Gradishar, William

AU - Bunta, Andrew D.

AU - Samaras, Athena T.

AU - Boyle, Simone N.

AU - Bennett, Charles L.

AU - West, Dennis P.

AU - Guise, Theresa

PY - 2011/2/1

Y1 - 2011/2/1

N2 - Purpose: Aromatase inhibitors (AIs) have been recently associated with hip fractures. We present a case series of breast cancer survivors and a systematic review of bone health care in breast cancer. Experimental Design: We completed clinical assessments and bone density testing (BMD) of hip fractures from January 2005 to December 2008. Prefracture and 12-month functional status was obtained. Systematic review included case reports and review of MEDLINE, PubMed, EMBASE, and Food and Drug Administration Adverse Event Reporting System (FDA AERS) from January 1998 to December 2008 (search terms: breast cancer, bone loss, osteopenia, osteoporosis, malignancy, cancer treatment, menopause, adriamycin, cytoxan, tamoxifen, and AIs). Results: Median age was 53.5 years; five women had osteopenia, one osteoporosis. Five cases were ER (+), and received surgery, XRT chemotherapy, and anastrozole. Functional decline was noted at 12 months, with difficulty in performing heavy housekeeping, climbing stairs, and shopping. The FDA AERS database included 228 cases of fractures associated with breast cancer therapy; 77/228 (29.4%) were hip or femur fractures. Among mid-life women under the age of 64 years there were 78 fractures; 15/228 (19%) were hip and femur fractures. AIs were the most common drug class associated with fractures (n = 149, 65%). Conclusions: Cancer treatment induced bone loss results in hip fractures among mid-life women with breast cancer. Hip fractures occur at younger ages and higher BMD than expected for patients in this age group without breast cancer. Hip fractures result in considerable functional decline. Greater awareness of this adverse drug effect is needed.

AB - Purpose: Aromatase inhibitors (AIs) have been recently associated with hip fractures. We present a case series of breast cancer survivors and a systematic review of bone health care in breast cancer. Experimental Design: We completed clinical assessments and bone density testing (BMD) of hip fractures from January 2005 to December 2008. Prefracture and 12-month functional status was obtained. Systematic review included case reports and review of MEDLINE, PubMed, EMBASE, and Food and Drug Administration Adverse Event Reporting System (FDA AERS) from January 1998 to December 2008 (search terms: breast cancer, bone loss, osteopenia, osteoporosis, malignancy, cancer treatment, menopause, adriamycin, cytoxan, tamoxifen, and AIs). Results: Median age was 53.5 years; five women had osteopenia, one osteoporosis. Five cases were ER (+), and received surgery, XRT chemotherapy, and anastrozole. Functional decline was noted at 12 months, with difficulty in performing heavy housekeeping, climbing stairs, and shopping. The FDA AERS database included 228 cases of fractures associated with breast cancer therapy; 77/228 (29.4%) were hip or femur fractures. Among mid-life women under the age of 64 years there were 78 fractures; 15/228 (19%) were hip and femur fractures. AIs were the most common drug class associated with fractures (n = 149, 65%). Conclusions: Cancer treatment induced bone loss results in hip fractures among mid-life women with breast cancer. Hip fractures occur at younger ages and higher BMD than expected for patients in this age group without breast cancer. Hip fractures result in considerable functional decline. Greater awareness of this adverse drug effect is needed.

UR - http://www.scopus.com/inward/record.url?scp=79551715682&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79551715682&partnerID=8YFLogxK

U2 - 10.1158/1078-0432.CCR-10-1595

DO - 10.1158/1078-0432.CCR-10-1595

M3 - Article

C2 - 21288927

AN - SCOPUS:79551715682

VL - 17

SP - 560

EP - 568

JO - Clinical Cancer Research

JF - Clinical Cancer Research

SN - 1078-0432

IS - 3

ER -