Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/17826
Title: Premenopausal women with early breast cancer treated with estradiol suppression have severely deteriorated bone microstructure.
Authors: Ramchand, Sabashini K;Seeman, Ego;Wang, Xiao-Fang;Ghasem-Zadeh, Ali;Francis, Prudence A;Ponnusamy, Evangeline J;Bardin, Michele S;Bui, Minh;Zebaze, Roger;Zajac, Jeffrey D;Grossmann, Mathis
Affiliation: Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Institute of Health and Ageing, Australian Catholic University, Melbourne, Australia
Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
Centre for Epidemiology and Biostatistics, Melbourne School of Population & Global Health, The University of Melbourne, Australia
Issue Date: Oct-2017
EDate: 2017-07-01
Citation: Bone 2017; 103: 131-135
Abstract: In premenopausal women with early estrogen-receptor-positive breast cancer, combined ovarian suppression and aromatase inhibition reduce estradiol production precipitously. The resulting unbalanced and rapid bone remodelling replaces older bone with less bone that is less fully mineralized. We hypothesized that these changes result in severe microstructural deterioration and reduced matrix mineralization density. Images of the distal radius and distal tibia were acquired using high-resolution peripheral quantitative computed tomography in a cross-sectional study of 27 premenopausal women, mean age 43.3years (range 30.4 to 53.7) with early breast cancer made estradiol deficient for 17months (range 6-120) using ovarian suppression and aromatase inhibition, 42 healthy age-matched premenopausal and 35 postmenopausal controls, mean age 62.6years (range 60.2 to 65.5). Cortical and trabecular microstructure were quantified using Strax software. Compared with premenopausal controls, the women with breast cancer had 0.75 SD (95% CI 0.21 to 1.29) lower distal radial trabecular bone volume due to 1.29 SD (0.71 to 1.87) fewer trabeculae. Cortical porosity was 1.25 SD (0.59 to 1.91) higher but cortical thickness was not reduced. Compared with postmenopausal controls 20years older, cases had comparable or lower trabecular bone volume and comparable cortical porosity and thickness. Matrix mineral density was 1.56 SD (0.90 to 2.22) lower than in premenopausal controls and 2.17 SD (1.50 to 2.84) lower than in postmenopausal controls. Results at the tibia were similar. The severe cortical porosity and trabecular deterioration associated with estradiol depletion and the longevity of premenopausal women with early breast cancer treated with endocrine therapy provide a compelling rationale to investigate the efficacy of antiresorptive therapy initiated at the time of breast cancer treatment.
URI: http://ahro.austin.org.au/austinjspui/handle/1/17826
DOI: 10.1016/j.bone.2017.06.024
ORCID: 0000-0002-9692-048X
0000-0001-8261-3457
PubMed URL: 28673637
Type: Journal Article
Subjects: Aromatase inhibition
Bone structure
Breast cancer
Estradiol depletion
Ovarian suppression
Premenopausal
Appears in Collections:Journal articles

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