Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20720
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dc.contributor.authorRamchand, Sabashini K-
dc.contributor.authorCheung, Yee-Ming Melody-
dc.contributor.authorYeo, Belinda-
dc.contributor.authorGrossmann, Mathis-
dc.date2019-04-01-
dc.date.accessioned2019-04-30T23:55:28Z-
dc.date.available2019-04-30T23:55:28Z-
dc.date.issued2019-
dc.identifier.citationThe Journal of Endocrinology 2019; 241(3): R111-R124en
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/20720-
dc.description.abstractIn women with oestrogen-receptor (ER) positive early breast cancer, oestradiol is important for breast cancer development and progression. Endocrine therapy prevents the deleterious effects of oestradiol in breast tissue by systemically depleting oestradiol concentration (aromatase inhibitors) or preventing its local action in breast tissue (selective oestrogen receptor modulators i.e. tamoxifen), thereby improving oncological outcomes. Use of aromatase inhibitors in postmenopausal women and ovarian function suppression with either tamoxifen or aromatase inhibition in premenopausal women, consequent to systemic oestradiol depletion, exerts detrimental effects on skeletal health. The oestradiol deficient state causes increased bone remodelling and a negative bone balance. This results in bone loss, microstructural deterioration and bone fragility predisposing to fractures. Similar effects are also seen with tamoxifen in premenopausal women. In contrast, use of tamoxifen in postmenopausal women appears to exert protective effects on bone but studies on fracture risk are inconclusive. The longevity of women with ER positive breast cancer treated with adjuvant endocrine therapy emphasises the need to mitigate the adverse skeletal effects of these therapies in order to maximise benefit. In general, fractures are associated with increased morbidity, mortality and are a high socio-economic burden. Whilst the efficacy of antiresorptive therapy in preventing bone mineral density loss in postmenopausal women has been established, further clinical trial evidence is required to provide guidance regarding fracture risk reduction, when to initiate and stop treatment, choice of agent and optimal management of bone health in premenopausal women receiving endocrine therapy. In addition, potential oncological benefits of antiresorptive therapies will also need to be considered.en
dc.language.isoeng-
dc.titleThe effects of adjuvant endocrine therapy on bone health in women with breast cancer.en
dc.typeJournal Articleen
dc.identifier.journaltitleThe Journal of Endocrinologyen
dc.identifier.affiliationDepartment of Endocrinology, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationMedical Oncologyen
dc.identifier.affiliationDepartment of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australiaen
dc.identifier.doi10.1530/JOE-19-0077en
dc.type.contentTexten
dc.identifier.orcid0000-0002-9218-9917en
dc.identifier.orcid0000-0001-8261-3457en
dc.identifier.pubmedid30991355-
dc.type.austinJournal Article-
dc.type.austinReview-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.fulltextNo Fulltext-
item.cerifentitytypePublications-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptEndocrinology-
crisitem.author.deptMedicine (University of Melbourne)-
crisitem.author.deptEndocrinology-
crisitem.author.deptMedicine (University of Melbourne)-
crisitem.author.deptOlivia Newton-John Cancer Research Institute-
crisitem.author.deptMedical Oncology-
crisitem.author.deptOlivia Newton-John Cancer Wellness and Research Centre-
crisitem.author.deptEndocrinology-
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