282P - Evaluation of bone mineral density (BMD) in early breast cancer (EBC) patients treated with up-front or switch schedules of aromatase inhibitors (AI...

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Anticancer agents
Complications/Toxicities of treatment
Breast Cancer
Biological therapy
Presenter Patrizia Seminara
Authors P. Seminara1, G. Manna2, A. Iannace2, T. Losanno2, A. Emiliani2, E. Franzese3, L. Frati2
  • 1Dipartimento Di Medicina Sperimentale, Sapienza University, 00187 - rome/IT
  • 2Department Of Experimental Medicine, Sapienza University, Rome/IT
  • 3Internal Medicine, Sapienza University, 00187 - rome/IT



Aromatase inhibitors (AIs) are the standard adjuvant treatment of hormone responsive early breast cancer (EBC) in postmenopausal women. AIs are well tolerated but are associated with specific toxicities, including effect on bone (accelerated bone loss, bone fracture, osteoporosis) and musculoskeletal symptoms (ostealgia, arthralgia, myalgia) Aim: The present observational study investigated the effect of BMD in postmenopausal women with EBC scheduled to receive AIs up-front or switch treatment after standard 2-3 years of adjuvant Tamoxifen (TAM-AIs).

Patients and methods

We reviewed data for 89 patients with hormone receptor-positive EBC: 64 postmenopausal women received up-front AIs for 5 years; 25 patients received TAM-AIs. BMD were assessed at baseline and during hormonal treatment once a year. Osteopenic patients received Calcium and vitamin D; osteoporotic patients received also oral biphosphonates.


No patient with a normal baseline BMD (T-score >-1) became osteoporotic during 5 years of follow-up. However, it was noted that more women receiving AIs up-front became osteopenic, as compared with TAMàAI treated women (AIs = 58% vs. TAM-AIs = 26%, p= <0.001). In addiction, women with osteoporosis at baseline, treated with biphosphonates, became osteopenic. Using the linear regression model approach we found that only patient with a baseline T-score less than -1.5 became osteoporotic on treatment (Fig.1). Supplementary comedications have improved reduction of musculoskeletal symptoms.


The data suggest that only those women with a T-score of less than -1.5 are at risk of developing osteoporosis during the AIs adjuvant therapy. This cut-off value might reduce the costs both for BMD monitoring and supplementary comedications. Finally, the correct management of treatment-related symptoms might improve patient's compliance and the adherence to treatment.


All authors have declared no conflicts of interest.