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Elemental composition of bone minerals in women with breast cancer treated with adjuvant tamoxifen

Breast Cancer Research and Treatment volume 37, pages 161–168 (1996)Cite this article

Abstract

Oestrogen levels play a major role in conditioning the rates of bone changes in women. Tamoxifen is a synthetic oestrogen antagonist commonly used as an adjuvant therapy for breast cancer. The goal of the present study was to study the amount and the elemental composition of bone minerals in the appedicular skeleton of women with breast cancer treated with adjuvant tamoxifen, as well as to investigate the possibility of increased risk for osteoporosis. Forty-two patients, aged 41–65 years, without skeletal metastases were studied. The mean duration of tamoxifen administration on a daily dose of 20 mg was 21 months (range 1–59 months). It was found that neither the amount of phosphorus in hands (HBP) nor forearm bone mineral content (BMC) differ statistically from those of age-matched healthy subjects. This was confirmed by reassessing bone mineral status after 30 months in 17 postmenopausal patients treated with tamoxifen for a mean time of 52 months. In conclusion, our data support that long-term tamoxifen treatment has no adverse or protective effect on the amount and elemental composition of the appedicular skeleton.

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References

  1. Glimcher M: The nature of the mineral component of bone and the mechanism of calcification. In: Avioli LV, Krane SM (eds) Metabolic bone disease, 2nd edition. WB Saunders, Philadelphia, 1990, pp 42–68

    Google Scholar 

  2. Consensus Development Conference: Prophylaxis and treatment of osteoporosis. Osteoporosis Int 1: 114–117, 1991

    Google Scholar 

  3. Avioli LV, Lindsay R: The female osteoporotic syndrome. In: Avioli LV, Krane SM (eds) Metabolic bone disease, 2nd edition. WB Saunders, Philadelphia, 1990, pp 397–451

    Google Scholar 

  4. Cole MP, Jone CT, Todd ID: A new anti-oestrogenic agent in breast cancer. An early clinical appraisal of ICI 46474. Br J Cancer 25: 270–275, 1971

    PubMed  Google Scholar 

  5. Prentice RL: Tamoxifen as a potential preventive agent in healthy post-menopausal women, (editorial). J Natl Cancer Inst 82: 1310–1311, 1990

    PubMed  Google Scholar 

  6. Nayfield SG, Karp JE, Ford LG, Dorr FF, Kramer BS: Potential role of tamoxifen in prevention of breast cancer. J Natl Cancer Inst 83: 1450–1459, 1991

    PubMed  Google Scholar 

  7. Goulding A, Gold E, Feng W: Tamoxifen in the rat prevents estrogen-deficiency bone loss elicited with LHRH agonist buserelin. Bone Miner 18: 143–152, 1992

    PubMed  Google Scholar 

  8. Jordan VC: Overview from the International Conference on long-term tamoxifen therapy for breast cancer (commentary). J Natl Cancer Inst 84: 231–234, 1992

    PubMed  Google Scholar 

  9. Glaros D, Xatzikonstantinou J, Leodiou J, Kalef-Ezra J: A partial body activation analysis technique for the measurement of phosphorus in bone. In: Ellis K, Yasumura S, Morgan W (eds)In Vivo Body Composition Studies. The Institute of Physical Sciences in Medicine, London, 1987, pp 295–299

    Google Scholar 

  10. Hatzikonstantinou I, Kalef-Ezra J, Glaros D:In vivo measurement of phosphorus in bones of the human hand by neutron activation analysis: Technical aspects and clinical applications. In: Bracale M, Denoth F (eds) Proceedings of the VI Mediterranean Conference on Medical Physics and Biological Engineering. Pisa, Italy, 1992, pp 755–758

  11. International Commission on Radiological Protection: 1990 Recommendations of the International Commission on Radiological Protection. ICRP Publication 60. Pergamon Press, Oxford, 1991

    Google Scholar 

  12. Kalef-Ezra J: Radiation burden to patients from non-invasive techniques forin vivo bone composition studies. In: Bracale M, Denoth F (eds) Proceedings of the VI Mediterranean Conference on Medical Physics and Biological Engineering, Pisa, Italy, 1992, pp 759–762

  13. Cameron J, Sorenson J: Measurement of bone mineralin vivo: An improved method. Science 142: 230–232, 1963

    PubMed  Google Scholar 

  14. Barnett E, Nordin BE: The radiological diagnosis of osteoporosis. Clin Radiol 11: 166–174, 1960

    PubMed  Google Scholar 

  15. O'Keeffe D: Morphometry. Radiol Clin North Am 29: 165–177, 1991

    PubMed  Google Scholar 

  16. Fornander T, Rutqvist LE, Wilking N, Carlström K, von Schoultz B: Oestrogenic effects of adjuvant tamoxifen in post-menopausal breast cancer. Eur J Cancer 29: 497–500, 1993

    Google Scholar 

  17. Basle MF, Mauras Y, Audran M, Clochon P, Rabel A, Allain P: Concentration of bone elements in osteoporosis. J Bone Miner Res 5: 41–47, 1990

    PubMed  Google Scholar 

  18. Kalef-Ezra J, Glaros D, Klouvas G, Hatzikonstantinou J, Karantanas A, Siamopoulos KC, Pavlidis N: New evidence that tamoxifen does not induce osteoporosis: A nuclear activation analysis and absorptiometry. Br J Radiol 65: 417–420, 1992

    PubMed  Google Scholar 

  19. Jordan VC, Phelps E, Lindgren JU: Effects of antiestrogens on bone in castrated and intact female rats. Breast Cancer Res Treat 10: 31–35 (1987)

    PubMed  Google Scholar 

  20. Feldmann S, Minne HW, Pafvizi S, Pfeifer M, Lempert UG, Bauss F, Ziegler R: Antiestrogen and antiandrogen administration reduce bone mass in the rat. Bone Miner 7: 245–254, 1987

    Google Scholar 

  21. Kalu DN, Salerno E, Liu CC, Echon R, Ray M, Garza-Zapata M, Hollis BW: A comparative study of the actions of tamoxifen, estrogen and progesterone in the ovariectomized rat. Bone Miner 15: 109–124, 1991

    PubMed  Google Scholar 

  22. Williams DC, Paul DC, Black LJ: Effects of estrogen and tamoxifen on serum osteocalcin in ovariectomized rats. Bone Miner 14: 205–220, 1991

    PubMed  Google Scholar 

  23. Goulding A, Gold E, Feng W: Tamoxifen in the rat prevents estrogen-deficiency bone loss elicited with the LHRG agonist buserelin. Bone Miner 18: 143–152, 1992

    PubMed  Google Scholar 

  24. Moon LY, Wakley GN, Turner RT: Dose-dependent effects of tamoxifen on long bones in growing rats: influence of ovarian status. Endocrinology 129: 1568–1574, 1991

    PubMed  Google Scholar 

  25. Love RR, Mazess RB, Tormey D, Barden HS, Newcomb PA, Jordan VC: Bone mineral density in women with breast cancer treated with adjuvant tamoxifen for at least two years. Breast Cancer Res Treatment 12: 297–302, 1988

    Google Scholar 

  26. Wright CDP, Evans WD, Mansel RE, Compston JE: Effects of long term tamoxifen therapy on bone mass (abstract). Bone 11: 221, 1990

    Google Scholar 

  27. Fornander T, Rutqvist LE, Sjöberg HE, Blomqvist L, Mattson A, Glas U: Long-term adjuvant tamoxifen in early breast cancer: Effect on bone mineral density in postmeno-pausal women. J Clin Oncol 8: 1019–1024, 1990

    PubMed  Google Scholar 

  28. Li I, Pitt PI, Sherwood R, Parsons V, Moniz C: Biochemical markers of bone turnover in women who had received tamoxifen for breast cancer (abstract). Bone Miner 17 (Suppl 1): 213, 1992

    Google Scholar 

  29. Neal AJ, Evans K, Hoskin PJ: Measurement of the effect of tamoxifen on bone mineral density (abstract). Br J Radiol 66 (Suppl): 49–50, 1993

    Google Scholar 

  30. Utz JP, Melton LJ, Kan BL: Risk of osteoporotic fractures in women with breast cancer: a population-based cohort study. J Chron Dis 40: 105–113, 1987

    PubMed  Google Scholar 

  31. Gotfredsen A, Christiansen C, Palshof T: The effect of tamoxifen on bone mineral content in premenopausal women with breast cancer. Cancer 53: 853–857, 1984

    PubMed  Google Scholar 

  32. Love RR, Mazess RB, Barden HS, Epstein S, Newcomb PA, Jordan VC, Carbone PP, DeMets DL: Effects of tamoxifen on bone mineral density in postmenopausal women with breast cancer. New Engl J Med 326: 852–856, 1992

    PubMed  Google Scholar 

  33. Fentiman IS, Calefi M, Rodin Aet al.: Bone mineral content of women receiving tamoxifen for mastalgia. Br J Cancer 60: 261–263, 1989

    Google Scholar 

  34. Fentiman IS, Saad Z, Caleffi M, Chaudary MA, Fogelman I: Tamoxifen protects against steroid induced bone loss. Eur J Cancer 28: 684–685, 1992

    PubMed  Google Scholar 

  35. Turken S, Siris E, Seldin D, Flaster E, Hyman G, Lindsay R: Effects of tamoxifen on spinal bone density in women with breast cancer. J Natl Cancer Inst 81: 1086–1088, 1989

    PubMed  Google Scholar 

  36. Ryan WG, Wolter J, Bagdade JD: Apparent beneficial effects on bone mineral content in patients with breast cancer: Preliminary results. Osteoporosis Int 2: 39–41, 1991

    Google Scholar 

  37. Ward RL, Morgan G, Dalley D, Kelly PJ: Tamoxifen reduces bone turnover and prevents lumbar spine and proximal bone loss in early postmenopausal women. Bone Miner 22: 87–94, 1993

    PubMed  Google Scholar 

  38. Kristensen B, Ejlertsen B, Dalgaard P, Larsen L, Holmegaard SN, Transböl I, Mouridsen HT: Tamoxifen and bone mineral metabolism in postmenopausal low risk breast cancer patients: A randomized study. J Clin Oncol 12: 992–997, 1994

    PubMed  Google Scholar 

  39. Wright CDP, Garrahan NJ, Stanton M, Gazet JC, Mansell RE, Compson JE: Effect of long-term tamoxifen therapy on calcellous bone remodeling and structure in women with breast cancer. J Bone Miner Res 9: 153–159, 1994

    PubMed  Google Scholar 

  40. Fentiman IS, Fogelman I: Breast cancer and osteoporosis — A bridge at last. Eur J Cancer 29A: 485–486, 1993

    PubMed  Google Scholar 

  41. Charkes DN, Silverman C: Does radiotherapy affect regional bone formation? (editorial). J Nuclear Med 33: 1780–1782, 1992

    Google Scholar 

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Authors and Affiliations

  1. From the Department of Medical Physics, Medical School, University of Ioannina, 451 10, Ioannina, Greece

    J. A. Kalef-Ezra (Associate Professor), A. Karantanas, I. Hatzikonstantinou & D. Glaros

  2. From the Department of Internal Medicine, Medical School, University of Ioannina, 451 10, Ioannina, Greece

    N. Pavlidis & G. Klouvas

  3. Medical School, University of Thessaly, 412 22, Larissa, Greece

    A. Karantanas

Authors
  1. J. A. Kalef-Ezra
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  2. N. Pavlidis
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  3. G. Klouvas
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  4. A. Karantanas
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  5. I. Hatzikonstantinou
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  6. D. Glaros
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Kalef-Ezra, J.A., Pavlidis, N., Klouvas, G. et al. Elemental composition of bone minerals in women with breast cancer treated with adjuvant tamoxifen. Breast Cancer Res Tr 37, 161–168 (1996). https://doi.org/10.1007/BF01806497

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  • DOI: https://doi.org/10.1007/BF01806497

Key words

  • absorptiometry
  • bone minerals
  • breast cancer
  • neutron activation analysis
  • tamoxifen

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