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Negative Impact of Aromatase Inhibitors on Proximal Femoral Bone Mass and Geometry in Postmenopausal Women with Breast Cancer

Authors
 Su Jin Lee  ;  Kyoung Min Kim  ;  J. Keenan Brown  ;  Alan Brett  ;  Yun Ho Roh  ;  Dae Ryong Kang  ;  Byeong Woo Park  ;  Yumie Rhee 
Citation
 Calcified Tissue International, Vol.97(6) : 551-559, 2015 
Journal Title
 Calcified Tissue International 
ISSN
 0171-967X 
Issue Date
2015
MeSH
Aromatase Inhibitors/adverse effects* ; Bone Density/drug effects ; Breast Neoplasms/drug therapy* ; Cross-Sectional Studies ; Female ; Femur Neck/diagnostic imaging* ; Femur Neck/drug effects* ; Humans ; Middle Aged ; Postmenopause ; Tomography, X-Ray Computed
Keywords
Aromatase inhibitor ; Bone geometry ; Bone strength ; Breast cancer ; Quantitative computed tomography
Abstract
Aromatase inhibitors (AIs), the standard therapy for estrogen receptor- or progesterone receptor-positive breast cancer in postmenopausal women, lead to increased hip fractures in breast cancer patients. To investigate the mechanism of increased incidence of hip fractures in breast cancer patients treated with AIs, we evaluated bone mineral density (BMD) in the cortical and trabecular compartments and assessed femoral geometry using quantitative computed tomography (QCT) in breast cancer patients. In total, 249 early breast cancer patients who underwent QCT in their fifties (mean age 54.3 years) were retrospectively analyzed. Proximal femoral BMD and geometrical parameters were compared. In all regions of the proximal femur, cortical areal BMDs were lower in the AI group than in the non-AI group (p < 0.05). Cortical thickness of the femoral neck, trochanter, and total hip was significantly lower in the AI group compared with the non-AI group (p < 0.05). Analysis of the narrowest section of the femoral neck showed significantly thinner cortical bone and smaller cortical area in the AI group than in the non-AI group (p < 0.05), especially in the superoposterior quadrant. Bone strength parameters in the femoral neck, such as the section modulus and cross-sectional moment of inertia, were significantly lower in the AI group than in the non-AI group (p < 0.05). In conclusion, AI treatment in breast cancer patients is associated with deterioration of femoral cortical BMD and geometry, which could contribute in site-specific weakened bone strength and increased incidence of hip fractures.
Full Text
http://link.springer.com/article/10.1007%2Fs00223-015-0046-x
DOI
10.1007/s00223-015-0046-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Roh, Yun Ho(노윤호)
Park, Byeong Woo(박병우) ORCID logo https://orcid.org/0000-0003-1353-2607
Lee, Su Jin(이수진) ORCID logo https://orcid.org/0000-0002-7325-2538
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141774
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