Impact of aromatase inhibitor treatment on vertebral morphology and bone mineral density in postmenopausal women with breast cancer


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Abstract

Objective:The aim of this study was to evaluate the impact of aromatase inhibitor (AI) treatment on vertebral morphology by vertebral fracture assessment in postmenopausal women with early-stage breast cancer.Methods:A clinical cross-sectional study was conducted. A group of 156 postmenopausal women with breast cancer (mean [SD] age, 60.4 [10.1] y; mean [SD] time since menopause, 11.7 [9.2] y) was included in the study. Eighty-two women received AI treatment, whereas 74 women did not. Women underwent extensive medical history check and risk factor assessment together with vertebral morphology and bone mineral density (BMD) evaluation.Results:In the studied population, the prevalence of vertebral fractures identified by vertebral fracture assessment was 16.6%. Multivariate analysis showed that AI treatment was significantly associated with vertebral fractures (adjusted P < 0.04). Women receiving AI treatment had a higher prevalence of vertebral fractures than women not treated with AIs (25.6% vs 4%). The risk of vertebral fractures in women treated with AIs was significantly higher than in non–AI-treated women (adjusted odds ratio, 4.7; P < 0.005). Vertebral fractures of the highest grade were identified at the lumbar spine. Women treated with AIs had a significantly lower BMD than women not treated with AIs (P < 0.01). Reduction of BMD was significantly associated with length of therapy, whereas there was no association between length of treatment and risk of vertebral fractures.Conclusions:AI treatment severely impacts vertebral morphology. Our study demonstrates a high prevalence of asymptomatic vertebral fractures in women treated with AIs.

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