Summary
Because treatment for breast cancer may adversely affect skeletal metabolism, we investigated vertebral fracture risk in women with non-metastatic breast cancer. The prevalence of vertebral fracture was similar in women at the time of first diagnosis to that in an age-matched sample of the general population. The incidence of vertebral fracture, however, was nearly five times greater than normal in women from the time of first diagnosis [odds ratio (OR), 4.7; 95% confidence interval (95% CI), 2.3–9.9], and 20-fold higher in women with soft-tissue metastases without evidence of skeletal metastases (OR, 22.7; 95% CI, 9.1–57.1). We conclude that vertebral fracture risk is markedly increased in women with breast cancer.
Similar content being viewed by others
Article PDF
Change history
16 November 2011
This paper was modified 12 months after initial publication to switch to Creative Commons licence terms, as noted at publication
References
Breast Cancer Task Force. Treatment Committee. National Cancer Institute, Breast Cancer (1977). Suggested protocol guidelines for combination chemotherapy trials and for combined modality trials. Washington, DC, US Department of Health, Education and Welfare. Publication no. (NIH) 77–1192.
Filipponi, P., Christallini, S., Rizzello, E., Policani, G., Fedeli, L. & Gregorio, F. et al (1996). Cyclical intravenous clodronate in postmenopausal osteoporosis. Results of a long-term trial. Bone 18: 179–184.
Hayward, J. L., Meakin, J. W. & Stewart, H. J. (1978). Assessment of response and recurrence in breast cancer. Semin Oncol 5: 445–449.
Kanis, J. A., Powles, T., Paterson, A. H. G., McCloskey, E. V. & Ashley, S. (1996). Clodronate decreases the frequency of skeletal metastases in women with breast cancer. Bone 19: 663–667.
Kanis, J. A., Delmas, P., Burckhardt, P. Cooper, C. & Torgerson D., on behalf of the EFFO (1997). Guidelines for the diagnosis and management of osteoporosis. Osteoporosis Int 7: 390–406.
McCloskey, E. V., Spector, T. D., Eyres, K. S., Fern, D. E., O’Rourke, N., Vasikaran, S. & Kanis, J. A. (1993). The assessment of vertebral deformity – a method for use in population studies and clinical trials. Osteoporosis Int 3: 138–147.
Orloff, J. J., Wu, T. L. & Stewart, A. F. (1989). Parathyroid hormone-like proteins: biochemical responses and receptor interactions. Endocrinol Rev 10: 476–495.
Paterson, A. H. G., Powles, T. J., Kanis, J. A., McCloskey, E., Hanson, J. & Ashley, S. (1993). Double-blind controlled trial of oral clodronate in patients with bone metastases from breast cancer. J Clin Oncol 11: 59–65.
Powell, G. J., Southby, J., Danks, J. A., Stillwell, R. G., Hayman, J. A. & Henderson, M. A. et al (1991). Localisation of parathyroid hormone-related protein in breast cancer metastases: increased incidence in bone compared with other sites. Cancer Res 51: 3059–3061.
Powles, T. J., Hickish, T., Kanis, J. A., Tidy, A. & Ashley, S. (1996). The effect of tamoxifen on lumbar bone mineral density in pre- and postmenopausal women. J Clin Oncol 14: 78–84.
Powles, T. J., McCloskey, E., Paterson, A. H. G., Ashley, S., Tidy, A. & Kanis, J. A. (1997). Oral clodronate reduces the loss of bone mineral density in women with operable primary breast cancer. J Clin Oncol, submitted for publication, ASBMR abstract,
Rivkees, A. S. & Crawford, J. D. (1988). The relationship of gonadal activity and chemotherapy-induced gonadal damage. JAMA 259: 2123–2125.
Saarto, T., Blomqvist, C., Valimaki, M., Makelo, P., Sarna, S. & Elomaa, I. (1997). Chemical castration induced by adjuvant cyclophosphamide, methotrexate and fluorouracil chemotherapy causes rapid bone loss that is reduced by clodronate: a randomised study in premenopausal breast cancer patients. J Clin Oncol 15: 1341–1347.
Spector, T. D., McCloskey, E., Doyle, D. V. & Kanis, J. A. (1993). Prevalence of vertebral fractures in women and the relationship with bone density and symptoms. The Chingford study. J Bone Miner Res 8: 817–822.
Taube, T., Elomaa, I., Blomqvist, C., Beneton, M. N. C. & Kanis, J. A. (1994). Histomorphometric evidence for osteoclast mediated bone resorption in metastatic breast cancer. Bone 15: 161–166.
Utz, J. P., Melton, L. J., Kan, S. H. & Riggs, B. L. (1987). Risk of osteoporotic fractures in women with breast cancer: a population-based cohort study. J Chron Dis 40: 105–113.
Author information
Authors and Affiliations
Rights and permissions
From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/
About this article
Cite this article
Kanis, J., McCloskey, E., Powles, T. et al. A high incidence of vertebral fracture in women with breast cancer. Br J Cancer 79, 1179–1181 (1999). https://doi.org/10.1038/sj.bjc.6690188
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bjc.6690188
Keywords
This article is cited by
-
The Impact of Non-bone Metastatic Cancer on Musculoskeletal Health
Current Osteoporosis Reports (2024)
-
Metabolic Health and Disease: A Role of Osteokines?
Calcified Tissue International (2023)
-
Osteocytes and Cancer
Current Osteoporosis Reports (2021)
-
Interventional Therapies for Pain in Cancer Patients: a Narrative Review
Current Pain and Headache Reports (2021)
-
Analyses of the association between breast cancer and osteoporosis/fracture history: a cross-sectional study using KoGES HEXA data
Archives of Osteoporosis (2021)