Osteoporosis management in patients with breast cancer: EMAS position statement

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• 作者：Florence A. Tré ; mollieres^a ; ^{tremollieres.fr@chu-toulouse.fr} ; Iuliana Ceausu^b ; Herman Depypere^c ; Irene Lambrinoudaki^d ; Alfred Mueck^e ; Faustino R. Pé ; rez-Ló ; pez^f ; Yvonne T. van der Schouw^g ; Levent M. Senturk^h ; Tommaso Simonciniⁱ ; John C. Stevenson^j ; Petra Stute^k ; Margaret Rees^l
• 关键词：Breast cancer ; Osteoporosis ; Fractures ; Screening ; Aromatase inhibitors ; Bisphosphonates ; Denosumab ; Adjuvant therapy
• 刊名：Maturitas
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：95
• 期：Complete
• 页码：65-71
• 全文大小：347 K
• 卷排序：95

文摘

Careful baseline evaluation of the risk of fracture is recommended in all premenopausal women with breast cancer and in postmenopausal women about to start treatment with aromatase inhibitors as part of their cancer treatment. For women with a T-score ≤−2 or those with two or more clinical risk factors for fracture, a pharmacological intervention is recommended, alongside vitamin D supplementation and adequate calcium intake. There is a consensus that bisphosphonates should be used to prevent the bone loss induced by cancer treatment, especially in women at intermediate or high risk of fracture. The use of denosumab could also be considered, although there is currently no specific guideline regarding this agent. Bisphosphonates, especially intravenous zoledronic acid, may have an anticancer effect, in that they reduce not only bone recurrence but also extra-skeletal metastasis and breast cancer mortality in postmenopausal women. Osteoporotic treatment should be continued at least until the adjuvant breast cancer treatment programme is complete or for even longer in those women with the highest baseline risk of fracture.