ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2019
Hormone therapy and osteoporosis in breast cancer survivors: assessment of risk and adherence to screening recommendations.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Risk of osteoporosis and fracture among patients with breast cancer: a systematic review and meta-analysis of cohort studies.Frontiers in oncology · 2026Pooled it
- Effect of prior breast cancer treatment on outcomes of reverse total shoulder arthroplasty.Journal of shoulder and elbow arthroplasty · 2026Article
- Prediction Model for Low Bone Mineral Density in Cancer Survivors and Age-Matched Controls Using a Causal Bayesian Network: A Nationwide Population-Based Study in Korea.Clinical Medicine Insights. Oncology · 2026Article
- Beyond Bone Loss: A Biology Perspective on Osteoporosis Pathogenesis, Multi-Omics Approaches, and Interconnected Mechanisms.Biomedicines · 2025Review
- Risk factors for and incidence of osteoporosis in patients with breast cancer by gender : a nationwide cohort study.Scientific reports · 2025Article
- The recent progress of endocrine therapy-induced osteoporosis in estrogen-positive breast cancer therapy.Frontiers in oncology · 2023Review
- Secondary Osteoporosis and Metabolic Bone Diseases.Journal of clinical medicine · 2022Review
- Adherence to Cancer Survivorship Care Guidelines and Health Care Utilization Patterns Among Nonmetastatic Breast Cancer Survivors in Singapore.JCO global oncology · 2022Article
- Results of Engineering, Primary Care, Oncology Collaborative Regarding a Survey of Primary Care on a Re-Engineered Survivorship Care Plan.Journal of cancer education : the official journal of the American Association for Cancer Education · 2022Article
- Updated guidance on the management of cancer treatment-induced bone loss (CTIBL) in pre- and postmenopausal women with early-stage breast cancer.Journal of bone oncology · 2021Review
- Update on the Role of Neuropeptide Y and Other Related Factors in Breast Cancer and Osteoporosis.Frontiers in endocrinology · 2021Review
- Dancing With Health: Quality of Life and Physical Improvements From an EU Collaborative Dance Programme With Women Following Breast Cancer Treatment.Frontiers in psychology · 2021Article
- Review
- High-Throughput Metabolomics Discovers Metabolic Biomarkers and Pathways to Evaluating the Efficacy and Exploring Potential Mechanisms of Osthole Against Osteoporosis Based on UPLC/Q-TOF-MS Coupled With Multivariate Data Analysis.Frontiers in pharmacology · 2020Article
- Article
- Correlation between bone mineral density and endometrial thickness over time in women with breast cancer history.Science progressArticle
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
The long-term impact of hormone therapy for breast cancer on risk of osteoporosis and the extent to which bone screening recommendations are implemented in daily practice remain unknown. We found that the aromatase inhibitor-induced risk of osteoporosis did not continue in the off-treatment follow-up. Adherence to screening recommendations was suboptimal.
introductionA case-cohort study was undertaken to better understand the impact of hormone therapy on breast cancer patients' risk of osteoporosis, and to estimate the extent to which current bone mineral density screening recommendations are implemented in real-life daily practice.
methodsThis study is based on 1692 female breast cancer survivors recruited from "Leumit" healthcare fund, who were diagnosed with primary nonmetastatic invasive breast cancer between 2002 and 2012. A 20% random subcohort was sampled at baseline, and all osteoporosis cases were identified. Adjusted hazard ratios (HR) with 95% confidence intervals (CI) were estimated by weighted Cox proportional hazards models.
resultsOf 1692 breast cancer survivors, 312 developed osteoporosis during a median follow-up of 5 years. The crude cumulative incidence of osteoporosis accounting for death as a competing risk was 25.7% (95% CI, 21.9-29.5%). In multivariable analyses, osteoporosis was positively associated with the aromatase inhibitor (AI) sequential treatment after tamoxifen (HR, 3.14; 95% CI, 1.44-6.88; P = .004) but was more pronounced with AI use as upfront monotherapy (HR, 5.53; 95% CI, 1.46-20.88; P = .012). This effect did not continue in the off-treatment follow-up. In subgroup analysis by menopausal status, tamoxifen did not seem to confer a protective effect on bone health in postmenopausal patients. Adherence to screening recommendations in AI-treated postmenopausal women was suboptimal, particularly at baseline and after 48 months of continuous AI use.
conclusionsThe natural, age-related reduction in bone density is exacerbated by breast cancer active AI treatment. Future research should focus on investigating screening adherence-related barriers/facilitators and effective strategies to bring practice in line with agreed standards.
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