Influence of compliance on bone mineral density changes in postmenopausal women with early breast cancer on Anastrozole

J Cancer Res Clin Oncol. 2013 Jun;139(6):915-23. doi: 10.1007/s00432-013-1402-8. Epub 2013 Feb 27.

Abstract

Purpose: Adjuvant treatment for hormone receptor-positive breast cancer in postmenopausal women with aromatase inhibitors is associated with increased bone loss depending on the compliance to treatment.

Methods: In this bone substudy, bone mineral density (BMD) was assessed by dual energy X-ray absorptiometry at baseline and after 12- and 24-month treatment in 63 patients receiving Anastrozole as adjuvant treatment for hormone receptor-positive early breast cancer. To minimize the effects of confounders, a matched pair analysis (compliant N = 21, non-compliant N = 21) was performed.

Results: Anastrozole treatment in compliant patients leads to a decrease in BMD (g/cm(2)) at lumbar spine and total hip from baseline to 12 and 24 months (-2.57 % P = 0.004; -2.02 % P = 0.05; -2.57 % P = 0.001 and -4.18 % P = 0.003, respectively) compared to non-compliant patients (-1.71 % P = 0.050; -2.00 % P = 0.085; -1.65 % P = 0.055 and -3.20 % P = 0.005, respectively).

Conclusions: Anastrozole treatment in compliant patients with breast cancer resulted in a larger, increase in bone loss at 12 and 24 months compared to non-compliant patients. Bone loss stabilized in both groups at the spine from 12- to 24-month treatment, whereas maintained at the total hip.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Aged
  • Anastrozole
  • Aromatase Inhibitors / adverse effects
  • Aromatase Inhibitors / therapeutic use
  • Bone Density / drug effects*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • Chemotherapy, Adjuvant
  • Female
  • Femur / diagnostic imaging
  • Femur / drug effects
  • Femur / metabolism
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / drug effects
  • Lumbar Vertebrae / metabolism
  • Middle Aged
  • Nitriles / adverse effects
  • Nitriles / therapeutic use*
  • Osteoporosis, Postmenopausal / chemically induced
  • Patient Compliance*
  • Postmenopause
  • Receptors, Steroid / metabolism
  • Time Factors
  • Treatment Outcome
  • Triazoles / adverse effects
  • Triazoles / therapeutic use*

Substances

  • Aromatase Inhibitors
  • Nitriles
  • Receptors, Steroid
  • Triazoles
  • Anastrozole