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Potential implications of adjuvant endocrine therapy for the oral health of postmenopausal women with breast cancer

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Abstract

Current adjuvant treatment modalities for breast cancer that express the estrogen receptor or progesterone receptor include adjuvant anti-estrogen therapies, and tamoxifen and aromatase inhibitors. Bone, including the jaw, is an endocrine-sensitive organ, as are other oral structures. This review examines the potential links between adjuvant anti-estrogen treatments in postmenopausal women with hormone receptor positive breast cancer and oral health. A search of PubMed, EMBASE, CENTRAL, and the Web of Knowledge was conducted using combinations of key terms “breast,” “cancer,” “neoplasm,” “Tamoxifen,” “Aromatase Inhibitor,” “chemotherapy,” “hormone therapy,” “alveolar bone loss,” “postmenopausal bone loss,” “estrogen,” “SERM,” “hormone replacement therapy,” and “quality of life.” We selected articles published in peer-reviewed journals in the English. The authors found no studies reporting on periodontal diseases, alveolar bone loss, oral health, or oral health-related quality of life in association with anti-estrogen breast cancer treatments in postmenopausal women. Periodontal diseases, alveolar bone density, tooth loss, and conditions of the soft tissues of the mouth have all been associated with menopausal status supporting the hypothesis that the soft tissues and bone of the oral cavity could be negatively affected by anti-estrogen therapy. As a conclusion, the impact of adjuvant endocrine breast cancer therapy on the oral health of postmenopausal women is undefined. The structures of the oral cavity are influenced by estrogen; therefore, anti-estrogen therapies may carry the risk of oral toxicities. Oral health care for breast cancer patients is an important but understudied aspect of cancer survivorship.

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Acknowledgments

This review was supported with funding from the Michigan Institute for Clinical Health Research/CTSA pilot grant UL1RR024986 and the National Institute on Dental and Craniofacial Research (NIDCR) grant 5K23DE020197 and 1K23DEO21779. The authors appreciate the assistance of Mark Mac Eachern of the University of Michigan, Taubman Health Sciences Library, for his assistance with the search of the scientific literature and Dr. Rudy Schmerl for his editorial assistance.

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The authors have no conflict of interest to declare in association with this paper

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Authors and Affiliations

  1. Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1011 North University Ave., Ann Arbor, MI, 48109-1078, USA

    L. Susan Taichman & Aaron M. Havens

  2. Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, 1011 North University Ave., Ann Arbor, MI, 48109-1078, USA

    Aaron M. Havens

  3. Division of Hematology and Oncology, Department of Internal Medicine, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA

    Catherine H. Van Poznak

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  1. L. Susan Taichman
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  2. Aaron M. Havens
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Correspondence to Catherine H. Van Poznak.

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Taichman, L.S., Havens, A.M. & Van Poznak, C.H. Potential implications of adjuvant endocrine therapy for the oral health of postmenopausal women with breast cancer. Breast Cancer Res Treat 137, 23–32 (2013). https://doi.org/10.1007/s10549-012-2217-z

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