Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/18026
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dc.contributor.authorGrossmann, Mathis-
dc.contributor.authorRamchand, Sabashini K-
dc.contributor.authorMilat, Frances-
dc.contributor.authorVincent, Amanda-
dc.contributor.authorLim, Elgene-
dc.contributor.authorKotowicz, Mark A-
dc.contributor.authorHicks, Jill-
dc.contributor.authorTeede, Helena-
dc.date2018-05-09-
dc.date.accessioned2018-07-10T06:22:36Z-
dc.date.available2018-07-10T06:22:36Z-
dc.date.issued2018-05-09-
dc.identifier.citationClinical Endocrinology 2018; 89(3): 280-296en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/18026-
dc.description.abstractTo formulate clinical consensus recommendations on bone health assessment and management of women with oestrogen receptor-positive early breast cancer receiving endocrine therapy, representatives appointed by relevant Australian Medical Societies used a systematic approach for adaptation of guidelines (ADAPTE) to derive an evidence-informed position statement addressing 5 key questions. Women receiving adjuvant aromatase inhibitors and the subset of premenopausal woman treated with tamoxifen have accelerated bone loss and increased fracture risk. Both bisphosphonates and denosumab prevent bone loss; additionally, denosumab has proven antifracture benefit. Women considering endocrine therapy need fracture risk assessment, including clinical risk factors, biochemistry and bone mineral density (BMD) measurement, with monitoring based on risk factors. Weight-bearing exercise, vitamin D and calcium sufficiency are recommended routinely. Antiresorptive treatment should be considered in women with prevalent or incident clinical or morphometric fractures, a T-score (or Z-scores in women <50 years) of <-2.0 at any site, or if annual bone loss is ≥5%, considering baseline BMD and other fracture risk factors. Duration of antiresorptive treatment can be individualized based on absolute fracture risk. Relative to their skeletal benefits, risks of adverse events with antiresorptive treatments are low. Skeletal health should be considered in the decision-making process regarding choice and duration of endocrine therapy. Before and during endocrine therapy, skeletal health should be assessed regularly, optimized by nonpharmacological intervention and where indicated antiresorptive treatment, in an individualized, multidisciplinary approach. Clinical trials are needed to better delineate long-term fracture risks of adjuvant endocrine therapy and to determine the efficacy of interventions designed to minimize these risks.en_US
dc.language.isoeng-
dc.subjectbone densityen_US
dc.subjectearly Breast canceren_US
dc.subjectfractureen_US
dc.subjectoestradiol deprivationen_US
dc.titleAssessment and management of bone health in women with oestrogen receptor-positive breast cancer receiving endocrine therapy: Position statement of the Endocrine Society of Australia, the Australian and New Zealand Bone & Mineral Society, the Australasian Menopause Society and the Clinical Oncology Society of Australia.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleClinical Endocrinologyen_US
dc.identifier.affiliationEndocrinologyen_US
dc.identifier.affiliationMedicine (University of Melbourne)en_US
dc.identifier.affiliationDepartment of Endocrinology, Monash Health, Clayton, Victoria, Australiaen_US
dc.identifier.affiliationHudson Institute of Medical Research, Clayton, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australiaen_US
dc.identifier.affiliationMonash Centre for Health Research and Implementation, Monash Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australiaen_US
dc.identifier.affiliationGarvan Institute of Medical Research, Darlinghurst, NSW, Australiaen_US
dc.identifier.affiliationSt Vincent's Hospital, University of New South Wales Sydney, Darlinghurst, NSW, Australiaen_US
dc.identifier.affiliationDeakin University, Geelong, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Endocrinology and Diabetes, University Hospital, Geelong, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Medicine, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Victoria, Australiaen_US
dc.identifier.affiliationBreast Cancer Network Australia, Camberwell, Victoria, Australiaen_US
dc.identifier.doi10.1111/cen.13735en_US
dc.type.contentTexten_US
dc.identifier.orcid0000-0001-8261-3457en_US
dc.identifier.orcid0000-0001-7609-577Xen_US
dc.identifier.pubmedid29741296-
dc.type.austinJournal Article-
dc.type.austinReview-
local.name.researcherGrossmann, Mathis
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptEndocrinology-
crisitem.author.deptEndocrinology-
crisitem.author.deptMedicine (University of Melbourne)-
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