Managing the Risk of Osteoporosis in Women With a History of Early Breast Cancer
October 01, 2004
Estrogen is known to play an important role in skeletal health. Femalebreast cancer patients who receive treatments that reduce estrogenlevels, such as aromatase inhibitors, may increase their risk of developingosteoporosis and their risk of fracture. Clinical guidelinesenable the physician to assess the risk of osteoporosis by patient historyand physical examination. For patients identified as being at risk, it isnecessary to test bone mineral density (BMD), using the result to determinewhich patients require treatment. Two groups can be identified asrequiring BMD assessment according to general guidelines: patients< 45 years old who become menopausal due to treatment, and breastcancer patients receiving aromatase inhibitors. Bisphosphonates appearto be the logical treatment of choice for breast cancer patients, asthey do not interact with the estrogen receptor. Although not all womenreceiving aromatase inhibitors will require additional treatment for bonehealth, postmenopausal women with a history of breast cancer at riskof osteoporosis should be identified, monitored, and managed accordingto practice guidelines.