Use of aromatase inhibitors in patients with breast cancer is associated with deterioration of bone microarchitecture and density

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dc.contributor.authorNunes, Frederico Arthur Pereira
dc.contributor.authorFarias, Maria Lucia Fleiuss de
dc.contributor.authorOliveira, Felipe Peres
dc.contributor.authorVieira Neto, Leonardo
dc.contributor.authorLima, Luis Felipe Cardoso
dc.contributor.authorParanhos Neto, Francisco de Paula
dc.contributor.authorMendonça, Laura Maria Carvalho de
dc.contributor.authorMadeira, Miguel
dc.date.accessioned2024-05-15T17:20:30Z
dc.date.available2024-05-15T17:20:30Z
dc.date.issued2021
dc.description.abstractABSTRACT Objective: To evaluate changes in bone density and architecture in postmenopausal women with breast cancer (BC) and use of aromatase inhibitor (AI). Subjects and methods: Thirty-four postmenopausal women with BC, without bone metastasis, renal function impairment and who were not receiving bone-active drugs were selected from a population of 523 outpatients treated for BC. According to the presence of hormonal receptors, HER2 and Ki67, seventeen had positive hormonal receptors and received anastrozole (AI group), and seventeen were triple-negative receptors (non-AI group), previously treated with chemotherapy. Areal bone mineral density (aBMD) and vertebral fracture assessment (VFA) analyses were performed by DXA; vBMD and bone microarchitecture were evaluated by HR-pQCT. Fracture risk was estimated using the FRAX tool. Results: No patient referred previous low-impact fracture, and VFA detected one moderate vertebral fracture in a non-AI patient. AI patients showed lower aBMD and BMD T-scores at the hip and 33% radius and a higher proportion of osteoporosis diagnosis on DXA (47%) vs non-AI (17.6%). AI group had significantly lower values for vBMD at the entire, cortical and trabecular bone compartments, cortical and trabecular thickness and BV/TV. They also had a higher risk for major fractures and for hip fractures estimated by FRAX. Several HR-pQCT parameters evaluated at distal radius and distal tibia were significantly associated with fracture risk. Conclusion: AI is associated with alterations in bone density and microarchitecture of both the cortical and trabecular compartments. These findings explain the overall increase in fracture risk in this specific population.
dc.identifier.doi10.20945/2359-3997000000385
dc.identifier.issn2359-3997
dc.identifier.otherS2359-39972021000400505-scl
dc.identifier.urihttps://repositorio-aptaregional.agricultura.sp.gov.br/handle/123456789/1297
dc.relation.ispartofArchives of Endocrinology and Metabolism
dc.subjectBreast cancer
dc.subjectosteoporosis
dc.subjectaromatase inhibitors (AI)
dc.subjectbone mineral density (BMD)
dc.subjecthigh resolution peripheral quantitative computed tomography (HR-pQCT)
dc.titleUse of aromatase inhibitors in patients with breast cancer is associated with deterioration of bone microarchitecture and density
dc.typeArtigos
oaire.citation.endPage511
oaire.citation.issue4
oaire.citation.startPage505
oaire.citation.volume65

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