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Changes in bone mineral density during 5 years of adjuvant treatment in premenopausal breast cancer patients

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Abstract

Purpose

Adjuvant treatment for breast cancer in postmenopausal women is a risk factor for bone loss. However, the association between bone mineral density (BMD) changes in premenopausal breast cancer patients and various adjuvant treatment regimens is not well characterized. In this study, we evaluated the changes in BMD according to adjuvant treatment in premenopausal women with breast cancer.

Methods

Between 2006 and 2010, BMD data of 910 premenopausal women with breast cancer before operation and 1, 2, 3.5, and 5 years post-operation were retrospectively analyzed. The patients were divided according to the type of treatment: observation (O), tamoxifen (T), chemotherapy (C), C followed by T (C → T), and gonadotropin-releasing hormone (GnRH) agonist with T (G + T).

Results

After 5 years of follow-up, BMD changes were similar between the T and O groups (all p > 0.05). Within 1 year of treatment, the C group showed the most significant BMD loss. The C → T and G + T groups showed more significant BMD loss in the lumbar spine and femur than the O and T groups (both p < 0.001, both). After 1 year of treatment, BMD loss in the lumbar spine was significantly greater in the C → T and G + T groups than in the T group; this tendency was maintained for 5 years of treatment (all p < 0.005).

Conclusion

Premenopausal women who received adjuvant treatment which induced menopause showed significant bone loss which lasted for 5 years. Although no significant difference was observed between the O and T groups, tamoxifen treatment during chemotherapy or GnRH agonist treatment might prevent bone loss.

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Authors and Affiliations

  1. Division of Breast, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Song pa-gu, Seoul, 05505, Republic of Korea

    Minsung Kim, Sei Hyun Ahn, Guiyun Sohn, Sae Byul Lee, Beom Seok Ko, Il Yong Chung, Jisun Kim, Jong Won Lee, Byung Ho Son & Hee Jeong Kim

  2. Saint Louis University School of Medicine, St. Louis, USA

    Hanna Kim

  3. Division of Endocrinology, Department of Medicine, and Department of Orthopedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, USA

    Vafa Tabatabaie

  4. I Am Clinic, Sungnam, Republic of Korea

    Sung Wook Choi

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  1. Minsung Kim
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Correspondence to Hee Jeong Kim.

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Kim, M., Kim, H., Ahn, S.H. et al. Changes in bone mineral density during 5 years of adjuvant treatment in premenopausal breast cancer patients. Breast Cancer Res Treat 180, 657–663 (2020). https://doi.org/10.1007/s10549-020-05566-w

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