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

Autor:	Nunes FAP; Divisão de Endocrinologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.; Departamento de Oncologia, Hospital Federal Cardoso Fontes, Rio de Janeiro, RJ, Brasil., de Farias MLF; Divisão de Endocrinologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil., Oliveira FP; Divisão de Endocrinologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil, felipemb86@yahoo.com.br., Vieira L Neto; Divisão de Endocrinologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil., Lima LFC; Programa de Engenharia Nuclear, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil., de Paula Paranhos F Neto; Divisão de Endocrinologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil., de Mendonça LMC; Divisão de Reumatologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil., Madeira M; Divisão de Endocrinologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil, migmadeira@gmail.com.
Jazyk:	angličtina
Zdroj:	Archives of endocrinology and metabolism [Arch Endocrinol Metab] 2021 Nov 03; Vol. 65 (4), pp. 505-511. Date of Electronic Publication: 2021 Jul 16.
DOI:	10.20945/2359-3997000000385
Abstrakt:	Objective: To evaluate changes in bone density and architecture in postmenopausal women with breast cancer (BC) and use of aromatase inhibitor (AI). 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.
Databáze:	MEDLINE
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