“…Hormonal therapy with aromatase inhibitors has in fact been found to be associated with risk of bone fracture in contrast to tamoxifen that has shown a protective effect (Breast Cancer Trials Committee, 1987; Fisher et al , 1989; Rutqvist et al , 2007; Cooke et al , 2008; Amir et al , 2011; Edwards et al , 2011). Other types of oncologic adjuvant treatment may also have potential negative effects on the skeleton independent of sex hormones (Pfeilschifter and Diel, 2000; Arnold, 2013). In addition, increasing evidence is suggesting that bone marrow microenvironment is involved in the metastatic process (Benoy et al , 2006; Semesiuk et al , 2013).…”