Evidence map›Paper›PMID 31912328›Full record

ArticleBreast cancer research and treatment2020

Serum bone markers and risk of osteoporosis and fragility fractures in women who received endocrine therapy for breast cancer: a prospective study.

Song Yao, Cecile A Laurent, Janise M Roh, Joan Lo, Li Tang, Theresa Hahn, Christine B Ambrosone, Lawrence H Kushi, Marilyn L Kwan

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Breast cancer research and treatment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Bone Health, Fragility Fractures, and the Hand Surgeon.Journal of hand surgery global online · 2025
    Review
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Song YaoDepartment of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA. song.yao@roswellpark.org.ORCID http://orcid.org/0000-0001-9442-1313
Cecile A LaurentDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Janise M RohDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Joan LoDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Li TangDepartment of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA.
Theresa HahnDepartment of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
Christine B AmbrosoneDepartment of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA.
Lawrence H KushiDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Marilyn L KwanDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Kaiser Permanente · USRoswell Park Comprehensive Cancer Center · US

Funding

Two-Spirit Films in Indigenous Cancer HealthP30CA016056 · NCI · ROSWELL PARK CANCER INSTITUTE CORP · PI MARK G FRATTINI · 1985 to 2026
$116.6M
The HMO Cancer Research Network (CRN)U19CA079689 · NCI · KAISER FOUNDATION HEALTH PLAN OF WASHINGTON · PI MAZOR, KATHLEEN MICHELE · 1999 to 2011
$62.6M
Prospective Study of Breast Cancer SurvivorshipR01CA105274 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI KUSHI, LAWRENCE H · 2004 to 2014
$19.9M
Infrastructure for Pathways, a Prospective Study of Breast Cancer SurvivorshipU01CA195565 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI AMBROSONE, CHRISTINE B., KUSHI, LAWRENCE H · 2016 to 2025
$18.8M
CRN4: Cancer Research Resources & Collaboration in Integrated Health Care SystemsU24CA171524 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI KUSHI, LAWRENCE H · 2012 to 2016
$16.0M
Lifestyle and Molecular Factors of Bone Health in Breast Cancer SurvivorsR01CA166701 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI KWAN, MARILYN L, YAO, SONG · 2012 to 2015
$2.5M
NCI NIH HHS P30 CA016056NCI NIH HHS P30 CA16056NCI NIH HHS R01 CA105274NCI NIH HHS R01 CA166701NCI NIH HHS U01 CA195565NCI NIH HHS U19 CA079689NCI NIH HHS U24 CA171524
6 · The paper itself

Abstract

purposeOsteoporosis and fragility fracture are major bone toxicities of aromatase inhibitors (AIs) for postmenopausal hormone receptor-positive breast cancer. Except for a few small studies on bone turnover markers and reduced bone mineral density after AI treatment, data on the associations of bone markers and risk of osteoporosis or fracture from prospective studies are lacking.

methodsIn a prospective study of 1709 women on AIs, two bone turnover markers, BALP and TRACP, and two bone regulatory markers, RANKL and OPG, were measured and examined in relation to risk of osteoporosis and fragility fractures during a median follow-up time of 6.1 years.

resultsHigher levels of BALP and TRACP were both associated with increased risk of osteoporosis and higher BALP/TRACP ratios were associated with lower risk of osteoporosis, but no associations were observed for fracture risk. Higher levels of OPG were associated with increased risk of fracture, whereas higher levels of RANKL were associated with lower risk. As a result, OPG/RANKL ratios were positively associated with fracture risk [hazard ratio (HR) = 2.49, 95% confidence interval (CI) 1.34-4.61]. After controlling for age and fracture history, the associations became non-significant but a suggestive trend remained (HR = 1.80, 95% CI 0.96-3.37).

conclusionOur study provides suggestive evidence for the potential utility of OPG/RANKL ratios in predicting risk of fracture in women treated with AIs for breast cancer. Further validation may be warranted.

Indexed as

Antineoplastic Agents, HormonalAromatase InhibitorsBiomarkersBone and BonesBone DensityBreast NeoplasmsFemaleFractures, BoneHumansIncidenceOdds RatioOsteoporosisProportional Hazards ModelsProspective StudiesRisk AssessmentAntineoplastic Agents, HormonalAromatase InhibitorsBiomarkersBone markersBreast cancerFractureOsteoporosis

Identifiers

PMID31912328
PMCPMC7171589
OpenAlexW2999952018

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.