ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025
Differential fracture risk in breast cancer patients based on endocrine therapy and age: a nationwide cohort study.
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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk of osteoporosis and fracture among patients with breast cancer: a systematic review and meta-analysis of cohort studies.Frontiers in oncology · 2026Pooled it
- Association Between Endocrine Therapy and Fracture Risk in Women with Breast Cancer in Germany-A Retrospective Cohort Study.Current oncology (Toronto, Ont.) · 2026Article
- Robust Association of Breast Cancer Co-morbidity Using Subtype-specific Expressed Genes.Current drug targets · 2026Article
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Abstract
purposeConcerns about the risk of osteoporosis and osteoporotic fractures following endocrine therapy have increased with increase in breast cancer survivors. This study aimed to evaluate the incidence of fractures by site between tamoxifen and aromatase inhibitor (AI) users and non-users at premenopausal and postmenopausal ages.
methodsThis retrospective cohort study used data from the Korea Central Cancer Registry and the Korean National Health Insurance Service. We analyzed 63,021 newly diagnosed breast cancer patients between 2008 and 2016. The risk of fractures was analyzed according to post-surgical endocrine therapy using the multivariable Cox proportional hazard model.
resultsHerein, 69.1% of the patients received endocrine therapy. The incidence rates of osteoporotic fractures per 1,000 person-years were 7.4 overall, 3.5 in those under 50, and 12.6 in those over 50. After adjusting for confounders, the tamoxifen group showed protection against any fractures in patients over 50 (HR = 0.75, 95% CI 0.62-0.89, p < 0.001) but not in those under 50. The AI group was associated with a significant increase in fractures in those under 50 (HR = 1.54, 95% CI 1.07-2.93, p = 0.019) but not in those over 50.
conclusionAmong breast cancer patients aged over 50 years, AI use was not associated with increased risk of compared to non-users. Tamoxifen use was linked to reduced risk of fracture, but not in patients under 50. Considering the relatively young age of breast cancer diagnosis in Korea, long-term follow-up studies are warranted. After adjusting for confounders including age, among breast cancer patients aged over 50 years, AI use was not associated with increased risk of fracture compared to non-users. Tamoxifen use was linked to reduced risk of fracture, but not in patients under 50.
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