Guidelines for diagnostics and treatment of aromatase inhibitor-induced bone loss in women with breast cancer

Abstract

The aim of this article is to inform about cancer treatment-induced bone loss, to identify patients at risk and those that can benefit from bone targeted treatment as well as highlight the importance of the multidisciplinary approach in the bone health in cancer care. Patients with breast cancer treated or intended to be treated with aromatase inhibitors belong to a high-risk group because their fracture risk increases up to 30% due to a significant decrease in bone mineral density within 6-12 months after the start of hormonal treatment. To evaluate bone status and predict risk for fractures, lateral thoracic and lumbar spine X-ray imaging, bone mineral density measurement by dual energy X-ray absorptiometry at the lumbar spine L1-L4 vertebrae and/or hip and fracture risk factors assessment are mandatory tests prior to hormonal treatment. Morbidity and mortality associated with bone loss can be prevented with appropriate screening, lifestyle interventions, and therapy. Algorithm for the management of bone health in breast cancer patients was established in Lithuania to screen patients with increased risk for bone loss and to provide adequate specific osteoporosis treatment.

The effects of adjuvant endocrine therapy on bone health in women with breast cancer

“…Several guidelines and position statements regarding the assessment and management of bone health in women with ER-positive early breast cancer treated with endocrine therapy have been developed by international societies (Gralow et al 2013, Paterson & Shea-Budgell 2013, Coleman et al 2014, Juozaityte et al 2014, Singapore Cancer Network Breast Cancer 2015, Hadji et al 2016, Tremollieres et al 2017, Grossmann et al 2018.…”

Cervical fractures of femoral bone in eldery patients: epidimeology and causative fractures (literature review)

“…Ризик переломів у жінок, які приймали інгібітори ароматази, був вищим на 15 %. У багатьох країнах існують клінічні рекомендації щодо профілактики та лікування медикаментозно індукованого остеопорозу [15,61,73,81,89]. Незважаючи на невеликі відмінності серед окремих клінічних рекомендацій, загалом визнано, що пацієнти, які тривало приймають глюкокортикоїди, агоністик гонадотропін-рилізинг гормону, інгібітори ароматази мають підвищений ризик переломів і здебільшого він досить високий.…”