Breast Cancer

, Volume 17, Issue 3, pp 212–217

Adverse events and bone health during anastrozole therapy in postmenopausal Japanese breast cancer patients

Authors

    • Department of Breast OncologySagara Hospital, Hakuaikai Medical Corporation
  • Shoichiro Kosha
    • Department of Obstetrics and Gynecology, Faculty of MedicineKagoshima University
  • Shinichi Baba
    • Department of Breast OncologySagara Hospital, Hakuaikai Medical Corporation
  • Fumiko Dokiya
    • Department of Breast OncologySagara Hospital, Hakuaikai Medical Corporation
  • Shugo Tamada
    • Department of Breast OncologySagara Hospital, Hakuaikai Medical Corporation
  • Yoshiaki Sagara
    • Department of Breast OncologySagara Hospital, Hakuaikai Medical Corporation
  • Yoshito Matsuyama
    • Department of Breast OncologySagara Hospital, Hakuaikai Medical Corporation
  • Yasuyo Ohi
    • Department of PathologySagara Hospital, Hakuaikai Medical Corporation
  • Mitsutake Ando
    • Department of Breast OncologySagara Hospital, Hakuaikai Medical Corporation
  • Yoshiaki Rai
    • Department of Breast OncologySagara Hospital, Hakuaikai Medical Corporation
  • Yoshiatsu Sagara
    • Department of Breast OncologySagara Hospital, Hakuaikai Medical Corporation
  • Tsutomu Douchi
    • Department of Obstetrics and Gynecology, Faculty of MedicineKagoshima University
Original Article

DOI: 10.1007/s12282-009-0135-7

Cite this article as:
Sagara, Y., Kosha, S., Baba, S. et al. Breast Cancer (2010) 17: 212. doi:10.1007/s12282-009-0135-7

Abstract

Background

Although anastrozole (ANA), an aromatase inhibitor (AI), has been widely used for breast cancer patients; adverse events during ANA therapy in Japanese patients have not been reported.

Methods

The study included 656 postmenopausal breast cancer patients receiving ANA as postoperative adjuvant therapy in our hospital. Adverse events during ANA therapy, such as musculoskeletal effects and cerebro- and cardiovascular accidents, were investigated over a 5-year period. The percentage changes in lumbar (L2-4) spine bone mineral density (BMD) were determined in 71 patients receiving ANA alone and 26 patients receiving bisphosphonate in combination with ANA for 7–24 months.

Results

The follow-up period ranged from 6 to 60 months (median 23 months). Joint pain, the most common adverse event, was observed in 3.6% (24/656) of the patients. Cerebral infarctions occurred in 0.3% (2/656) of the patients, and no cardiovascular accidents occurred. Bone fractures occurred in nine patients receiving ANA alone. The mean age and BMD of the nine patients were 67.6 years and 71.8% (compared to the young adult mean BMD), respectively. Accumulated and annual fracture rates were 1.3 and 0.8%, respectively. A decrease in BMD was observed in 62.0% (44/71) of the ANA group compared to 26.9% (7/26) of the combination bisphosphonate group (P < 0.01).

Conclusion

Incidence of adverse events during AI therapy in this Japanese postmenopausal population appears to be lower than that of the ATAC trial. The incidence of bone fractures during AI therapy is lower in Japan, and the addition of bisphosphonates enhances bone health. We should perform a prospective trial in the future to investigate the precise risk of bone fractures in Japanese patients.

Keywords

Breast cancer Aromatase inhibitor Anastrozole Bone mineral density Fracture

Copyright information

© The Japanese Breast Cancer Society 2009