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Erschienen in: Osteoporosis International 2/2015

01.02.2015 | Short Communication

Minimal-trauma fracture in women with breast cancer surviving for at least 5 years from diagnosis

verfasst von: P. J. Robinson, R. J. Bell, C. S. Zecena Morales, P. Fradkin, S. R. Davis

Erschienen in: Osteoporosis International | Ausgabe 2/2015

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Abstract

Summary

Minimal-trauma fracture is an important issue in breast cancer survivors, especially rib fracture. The likelihood of fracture is affected by menopausal status and a diagnosis of osteoporosis prior to breast cancer. Most women reported at least one assessment of bone mineral density.

Introduction

We have investigated the self-reported frequency and pattern of minimal-trauma fracture (MTF) in breast cancer (BC) survivors at least 5 years from diagnosis, along with the use of bone mineral density (BMD) assessment.

Methods

This study was carried out within the Bupa Health Foundation Health and Wellbeing After Breast Cancer Study which is a questionnaire-based prospective cohort study of 1683 women diagnosed with their first invasive breast cancer between 2004 and 2006 and followed for at least 5 years.

Results

One thousand two hundred and five women, who remained free of recurrence or new breast cancer, completed the fifth annual follow-up. One hundred sixty-four (13.6 %) reported at least one MTF. Rib fracture was the most common (52 fractures in 46 women). Compared with women who remained pre-/peri-menopausal, either being postmenopausal at diagnosis (OR 3.53, 95 % Confidence Interval (CI) 1.09–11.44, p = 0.036) or changing from pre- to postmenopausal during follow-up (OR 3.97, 95 % CI 1.21–13.10, p = 0.023) was associated with a higher likelihood of fracture, as was having a diagnosis of osteoporosis at the time of diagnosis (OR 1.74, 95 % CI 1.00–2.99, p = 0.047). Most women (64.9 %) reported at least one BMD assessment.

Conclusions

Overall MTF is a problem for breast cancer survivors, with rib fracture a particular issue for women in our study. Both pre-existing osteoporosis and being postmenopausal are risk factors for subsequent MTF in women treated for breast cancer. Clinicians need to be mindful of fracture prevention medication in these groups.
Literatur
2.
Zurück zum Zitat Howell A, Cuzick J, Baum M, Buzdar A, Dowsett M, Forbes JF, Hoctin-Boes G, Houghton J, Locker GY, Tobias JS (2005) Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years’ adjuvant treatment for breast cancer. Lancet 365:60–62PubMedCrossRef Howell A, Cuzick J, Baum M, Buzdar A, Dowsett M, Forbes JF, Hoctin-Boes G, Houghton J, Locker GY, Tobias JS (2005) Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years’ adjuvant treatment for breast cancer. Lancet 365:60–62PubMedCrossRef
3.
Zurück zum Zitat Burstein HJ, Prestrud AA, Seidenfeld J et al (2010) American Society of Clinical Oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. J Clin Oncol Off J Am Soc Clin Oncol 28:3784–3796CrossRef Burstein HJ, Prestrud AA, Seidenfeld J et al (2010) American Society of Clinical Oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. J Clin Oncol Off J Am Soc Clin Oncol 28:3784–3796CrossRef
4.
Zurück zum Zitat Aebi S, Davidson T, Gruber G, Cardoso F (2011) Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol Off J Eur Soc Med Oncol/ESMO 22(Suppl 6):vi12–24 Aebi S, Davidson T, Gruber G, Cardoso F (2011) Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol Off J Eur Soc Med Oncol/ESMO 22(Suppl 6):vi12–24
5.
Zurück zum Zitat National Comprehensive Cancer Network (2012) NCCN Clinical Practice Guidelines in Oncology Breast Cancer Version 2 National Comprehensive Cancer Network (2012) NCCN Clinical Practice Guidelines in Oncology Breast Cancer Version 2
6.
Zurück zum Zitat Reid DM, Doughty J, Eastell R, Heys SD, Howell A, McCloskey EV, Powles T, Selby P, Coleman RE (2008) Guidance for the management of breast cancer treatment-induced bone loss: a consensus position statement from a UK Expert Group. Cancer Treat Rev 34(Suppl 1):S3–18PubMedCrossRef Reid DM, Doughty J, Eastell R, Heys SD, Howell A, McCloskey EV, Powles T, Selby P, Coleman RE (2008) Guidance for the management of breast cancer treatment-induced bone loss: a consensus position statement from a UK Expert Group. Cancer Treat Rev 34(Suppl 1):S3–18PubMedCrossRef
7.
Zurück zum Zitat Hillner BE, Ingle JN, Chlebowski RT et al (2003) American Society of Clinical Oncology 2003 update on the role of bisphosphonates and bone health issues in women with breast cancer. J Clin Oncol Off J Am Soc Clin Oncol 21:4042–4057CrossRef Hillner BE, Ingle JN, Chlebowski RT et al (2003) American Society of Clinical Oncology 2003 update on the role of bisphosphonates and bone health issues in women with breast cancer. J Clin Oncol Off J Am Soc Clin Oncol 21:4042–4057CrossRef
8.
Zurück zum Zitat Lijovic M, Davis SR, Fradkin P, La China M, Farrugia H, Wolfe R, Bell RJ (2008) Use of a cancer registry is preferable to a direct-to-community approach for recruitment to a cohort study of wellbeing in women newly diagnosed with invasive breast cancer. BMC Cancer 8:126PubMedCentralPubMedCrossRef Lijovic M, Davis SR, Fradkin P, La China M, Farrugia H, Wolfe R, Bell RJ (2008) Use of a cancer registry is preferable to a direct-to-community approach for recruitment to a cohort study of wellbeing in women newly diagnosed with invasive breast cancer. BMC Cancer 8:126PubMedCentralPubMedCrossRef
9.
Zurück zum Zitat Bell RJ, Schwarz M, Fradkin P, Robinson PJ, Davis SR (2013) Patterns of use of oral adjuvant endocrine therapy in Australian breast cancer survivors 5 years from diagnosis. Menopause Bell RJ, Schwarz M, Fradkin P, Robinson PJ, Davis SR (2013) Patterns of use of oral adjuvant endocrine therapy in Australian breast cancer survivors 5 years from diagnosis. Menopause
10.
Zurück zum Zitat Cooley H, Jones G (2001) A population-based study of fracture incidence in southern Tasmania: lifetime fracture risk and evidence for geographic variations within the same country. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 12:124–130 Cooley H, Jones G (2001) A population-based study of fracture incidence in southern Tasmania: lifetime fracture risk and evidence for geographic variations within the same country. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 12:124–130
11.
Zurück zum Zitat Shuaib W, Vijayasarathi A, Tiwana MH, Johnson JO, Maddu KK, Khosa F (2014) The diagnostic utility of rib series in assessing rib fractures. Emerg Radiol 21:159–164PubMedCrossRef Shuaib W, Vijayasarathi A, Tiwana MH, Johnson JO, Maddu KK, Khosa F (2014) The diagnostic utility of rib series in assessing rib fractures. Emerg Radiol 21:159–164PubMedCrossRef
12.
Zurück zum Zitat Melton LJ 3rd, Hartmann LC, Achenbach SJ, Atkinson EJ, Therneau TM, Khosla S (2012) Fracture risk in women with breast cancer: a population-based study. J Bone Miner Res Off J Am Soc Bone Miner Res 27:1196–1205CrossRef Melton LJ 3rd, Hartmann LC, Achenbach SJ, Atkinson EJ, Therneau TM, Khosla S (2012) Fracture risk in women with breast cancer: a population-based study. J Bone Miner Res Off J Am Soc Bone Miner Res 27:1196–1205CrossRef
13.
Zurück zum Zitat Chen Z, Maricic M, Bassford TL, Pettinger M, Ritenbaugh C, Lopez AM, Barad DH, Gass M, Leboff MS (2005) Fracture risk among breast cancer survivors: results from the Women’s Health Initiative Observational Study. Arch Intern Med 165:552–558PubMedCrossRef Chen Z, Maricic M, Bassford TL, Pettinger M, Ritenbaugh C, Lopez AM, Barad DH, Gass M, Leboff MS (2005) Fracture risk among breast cancer survivors: results from the Women’s Health Initiative Observational Study. Arch Intern Med 165:552–558PubMedCrossRef
14.
Zurück zum Zitat Jones G, Nguyen T, Sambrook PN, Kelly PJ, Gilbert C, Eisman JA (1994) Symptomatic fracture incidence in elderly men and women: the Dubbo Osteoporosis Epidemiology Study (DOES). Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 4:277–282 Jones G, Nguyen T, Sambrook PN, Kelly PJ, Gilbert C, Eisman JA (1994) Symptomatic fracture incidence in elderly men and women: the Dubbo Osteoporosis Epidemiology Study (DOES). Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 4:277–282
15.
Zurück zum Zitat Sanders KM, Seeman E, Ugoni AM, Pasco JA, Martin TJ, Skoric B, Nicholson GC, Kotowicz MA (1999) Age- and gender-specific rate of fractures in Australia: a population-based study. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 10:240–247 Sanders KM, Seeman E, Ugoni AM, Pasco JA, Martin TJ, Skoric B, Nicholson GC, Kotowicz MA (1999) Age- and gender-specific rate of fractures in Australia: a population-based study. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 10:240–247
16.
Zurück zum Zitat Chang KP, Center JR, Nguyen TV, Eisman JA (2004) Incidence of hip and other osteoporotic fractures in elderly men and women: Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res Off J Am Soc Bone Miner Res 19:532–536CrossRef Chang KP, Center JR, Nguyen TV, Eisman JA (2004) Incidence of hip and other osteoporotic fractures in elderly men and women: Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res Off J Am Soc Bone Miner Res 19:532–536CrossRef
17.
Zurück zum Zitat Neuner JM, Yen TW, Sparapani RA, Laud PW, Nattinger AB (2011) Fracture risk and adjuvant hormonal therapy among a population-based cohort of older female breast cancer patients. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 22:2847–2855 Neuner JM, Yen TW, Sparapani RA, Laud PW, Nattinger AB (2011) Fracture risk and adjuvant hormonal therapy among a population-based cohort of older female breast cancer patients. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 22:2847–2855
18.
Zurück zum Zitat Omland LM, Tell GS, Ofjord S, Skag A (2000) Risk factors for low bone mineral density among a large group of Norwegian women with fractures. Eur J Epidemiol 16:223–229PubMedCrossRef Omland LM, Tell GS, Ofjord S, Skag A (2000) Risk factors for low bone mineral density among a large group of Norwegian women with fractures. Eur J Epidemiol 16:223–229PubMedCrossRef
19.
Zurück zum Zitat Chan MY, Frost SA, Center JR, Eisman JA, Nguyen TV (2014) Relationship Between Body Mass Index and Fracture Risk Is Mediated By Bone Mineral Density. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research Chan MY, Frost SA, Center JR, Eisman JA, Nguyen TV (2014) Relationship Between Body Mass Index and Fracture Risk Is Mediated By Bone Mineral Density. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
20.
Zurück zum Zitat Tremollieres F, Ribot C (2010) Bone mineral density and prediction of non-osteoporotic disease. Maturitas 65:348–351PubMedCrossRef Tremollieres F, Ribot C (2010) Bone mineral density and prediction of non-osteoporotic disease. Maturitas 65:348–351PubMedCrossRef
21.
Zurück zum Zitat Eastell R, Adams JE, Coleman RE, Howell A, Hannon RA, Cuzick J, Mackey JR, Beckmann MW, Clack G (2008) Effect of anastrozole on bone mineral density: 5-year results from the anastrozole, tamoxifen, alone or in combination trial 18233230. J Clin Oncol Off J Am Soc Clin Oncol 26:1051–1057CrossRef Eastell R, Adams JE, Coleman RE, Howell A, Hannon RA, Cuzick J, Mackey JR, Beckmann MW, Clack G (2008) Effect of anastrozole on bone mineral density: 5-year results from the anastrozole, tamoxifen, alone or in combination trial 18233230. J Clin Oncol Off J Am Soc Clin Oncol 26:1051–1057CrossRef
22.
Zurück zum Zitat Overgaard M (1988) Spontaneous radiation-induced rib fractures in breast cancer patients treated with postmastectomy irradiation. A clinical radiobiological analysis of the influence of fraction size and dose–response relationships on late bone damage. Acta Oncol 27:117–122PubMedCrossRef Overgaard M (1988) Spontaneous radiation-induced rib fractures in breast cancer patients treated with postmastectomy irradiation. A clinical radiobiological analysis of the influence of fraction size and dose–response relationships on late bone damage. Acta Oncol 27:117–122PubMedCrossRef
Metadaten
Titel
Minimal-trauma fracture in women with breast cancer surviving for at least 5 years from diagnosis
verfasst von
P. J. Robinson
R. J. Bell
C. S. Zecena Morales
P. Fradkin
S. R. Davis
Publikationsdatum
01.02.2015
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 2/2015
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-014-2945-5

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