Effect of denosumab on bone mineral density (T-score classification of −1.0 to −2.5) in postmenopausal Japanese women receiving adjuvant aromatase inhibitors for nonmetastatic breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 552-552
Author(s):  
Katsuhiko Nakatsukasa ◽  
Takayuki Matsuda ◽  
Tetsuya Taguchi
Keyword(s):  
Breast Cancer ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Loss ◽  
Femoral Neck ◽  
Prospective Study ◽  
Hormone Receptor ◽  
Mineral Density ◽  
Hormone Receptor Positive ◽  
The Right

552 Background: Adjuvant aromatase inhibitor (AI) therapy is well established in postmenopausal women with hormone receptor-positive breast cancer, but such therapy is associated with bone loss and increased fracture risk. Denosumab, a fully human monoclonal antibody against receptor of nuclear-κB ligand, was previously proven to protect against AI-induced bone loss. In Japan, however, the efficacy of denosumab in the treatment of AI-associated bone loss has not been proven in a prospective study. Methods: This non-randomized prospective study was conducted at four institutions in Japan. we prospectively evaluated the bone mineral density (BMD) of the lumbar spine and bilateral femoral neck in hormone-receptor positive clinical stageⅠ–ⅢA, postoperative postmenopausal breast cancer patients who were scheduled for treatment with AI as adjuvant endocrine therapy or during AI adjuvant therapy. They received supplemental calcium, vitamin D and subcutaneous denosumab 60mg (n=103) every six months. At enrollment, all patients were required to have evidence of low bone mass, excluding osteoporosis. The primary endpoint was percentage change in lumbar spine BMD from baseline to month 12. The secondary endpoint was percentage change in bilateral femoral neck BMD from baseline to month 12. This is the first trial where the right and left femoral neck BMD are measured separately. Results: We enrolled 103 patients between November, 2014 to October, 2016. At 12 months, lumber spine BMD increased by 4.7 %. The patients who were administered prior AI therapy (n=60) had a 4.8 % increase, and the patients without prior AI therapy (n=40) had a 4.6 % increase. At 12 months, the right and left femoral neck BMD increased by 2.9 % and 2.0 %, respectively. Hypocalcemia ≥ grade2, osteonecrosis of the jaw (ONJ) and non-traumatic clinical fracture were absent in this study. Conclusions: Twice-yearly treatment with denosumab was associated with consistently greater gains in BMD among Japanese women receiving adjuvant AI therapy, regardless of whether prior AI therapy was administered. Clinical trial information: UMIN000013863.

The effect of anastrozole on bone mineral density during the first 5 years of adjuvant treatment in postmenopausal women with early breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11604-e11604
Author(s):  
Hiroaki Inoue ◽  
Akira Hirano ◽  
Kaoru Ogura ◽  
Akinori Hattori ◽  
Mari Kamimura ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Loss ◽  
Adjuvant Therapy ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Mineral Density ◽  
Alendronate Treatment

e11604 Background: Adjuvant therapy with aromatase inhibitors (AI) is associated with increased bone loss in postmenopausal women. We assessed changes in bone mineral density (BMD) from baseline to 60 months of treatment in patients receiving anastrozole (ANA) as initial adjuvant therapy with/without oral bisphosphonates (Bis). Methods: Postmenopausal women with endocrine responsive breast cancer receiving ANA as adjuvant therapy at our hospital since 2004 were enrolled in this study. BMD was assessed by dual-energy X-ray absorptiometry at baseline and after 6, 12, 24, 36, 48 and 60 months. Oral Bis (risedronate or alendronate) treatment was initiated when patients were diagnosed as having osteoporosis with a T-score of -2.5 or lower. Results: Fifty-seven patients were enrolled in the study between 2004 and 2011. Patients’ median age was 65 years (range 50~85) and the median follow-up period was 46.3 months (9.6~83.8). Thirty-five patients were administered Bis (risedronate in 27 patients, alendronate in 8 patients). Within 6 months of hormone therapy, BMD decreased by 0.3% from baseline at the lumbar spine and BMD decreased by 1.2% at the femoral neck. However, BMD increased by 2.8% at the lumbar spine and BMD decreased 0.5% at the femoral neck for 60 months of treatment. In patients treated with upfront Bis (n=24), 4.9% BMD increase from baseline was noted at the lumbar spine whereas in those without Bis (n=20) BMD decreased by 4.6% from baseline within 24 months (p=0.0002). Fractures were observed in 4 patients (7.0%), and 1 patient (1.8%) had fragility fracture. Conclusions: Oral Bis prevented ANA-induced bone loss, and upfront treatment of Bis significantly increased BMD at the lumber spine.

Characteristics of bone mineral density at the time of diagnosis in postmenopausal breast cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22187-e22187
Author(s):  
H. J. Kim ◽  
E. Park ◽  
W. Lim ◽  
J. Sei ◽  
B. Koh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mass ◽  
Cancer Patients ◽  
Bone Mineral ◽  
Hormone Receptor ◽  
Breast Cancer Patients ◽  
Mineral Density ◽  
Hormone Receptor Positive

e22187 Background: Bone mass has been proposed as a marker of cumulative exposure to estrogen in women. We have studied the association between bone mass and breast cancer in postmenopausal women. Methods: We investigated the association between bone mineral density(BMD), as measured at the lumbar spine and femoral neck and the breast cancer in women age 50 or older, who were received an initial diagnosis of stage 0-III breast cancer, confirmed by pathologic assessment of breast tissue. We recruited 718 women with newly diagnosed breast cancer in a Asan Medical Center from 1, Jun. 2006 to 31, Dec. 2007. BMD was measured by lunar EXPERT-XL for breast cancer patients Results: Median age at diagnosis was 58 (range 47–82). Patients with higher BMD at lumbar spine were found to have low grade disease (p<0.005). The patients with hormone receptor positive breast tumor showed higher BMD at lumbar spine and lower serum 25(OH)D than hormone receptor negative tumor. Serum estradiol level did not show a relation to BMD. There were no significant differences between breast cancer stage and serum 25(OH)D and BMD. Conclusions: The patients who have hormone receptor positive breast cancer had higher Lumbar spine BMD and lower 25(OH)D than hormone receptor negative patients. No significant financial relationships to disclose.

Bisphosphonate risedronate prevents bone loss in women with artificial menopause due to chemotherapy of breast cancer: a double-blind, placebo-controlled study.

1997 ◽  
Vol 15 (3) ◽  
pp. 955-962 ◽  
Author(s):  
P D Delmas ◽  
R Balena ◽  
E Confravreux ◽  
C Hardouin ◽  
P Hardy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lumbar Spine ◽  
Bone Loss ◽  
Femoral Neck ◽  
White Women ◽  
Treatment Withdrawal ◽  
Controlled Study ◽  
Treatment Needs ◽  
Mineral Density ◽  
Double Blind

PURPOSE To determine the effectiveness and safety of the bisphosphonate risedronate in preventing bone loss in young women with breast cancer and early menopause induced by chemotherapy who are at major risk for the development of postmenopausal osteoporosis. PATIENTS AND METHODS Fifty-three white women, aged 36 to 55 years, with breast cancer and artificially induced menopause were stratified according to prior tamoxifen use. Thirty-six patients received tamoxifen (20 mg/d). Within each stratum, patients were randomly assigned to receive risedronate (n = 27) or placebo (n = 26). Treatment consisted of eight cycles oral risedronate 30 mg/d or placebo daily for 2 weeks followed by 10 weeks of no drug (12 weeks per cycle). Patients were monitored for a third year without treatment. RESULTS Main outcomes of the study were changes in lumbar spine and proximal femur (femoral neck, trochanter, and Ward's triangle) bone mineral density (BMD), and biochemical markers of bone turnover. In contrast to a significant decrease of BMD at the lumbar spine and hip in the placebo group, there was an increase in BMD in the risedronate group. On treatment withdrawal, bone loss ensued, which suggests that treatment needs to be continuous to maintain a protective effect on bone mass. At 2 years, the mean difference (+/- SEM) between groups was 2.5% +/- 1.2%, (95% confidence interval [CI], 0.2 to 4.9) at the lumbar spine (P = .041) and 2.6% +/- 1.1%, (95% CI, 0.3 to 4.8) at the femoral neck (P = .029). Similar results were observed at the hip trochanter. Results by stratum indicate a beneficial, although partial, effect of tamoxifen in reducing bone loss. Risedronate was well tolerated and showed a good safety profile, with no evidence of laboratory abnormalities. CONCLUSION Risedronate appears to be a safe treatment that prevents both trabecular and cortical bone loss in women with menopause induced by chemotherapy for breast cancer.

Chemical castration induced by adjuvant cyclophosphamide, methotrexate, and fluorouracil chemotherapy causes rapid bone loss that is reduced by clodronate: a randomized study in premenopausal breast cancer patients.

1997 ◽  
Vol 15 (4) ◽  
pp. 1341-1347 ◽  
Author(s):  
T Saarto ◽  
C Blomqvist ◽  
M Välimäki ◽  
P Mäkelä ◽  
S Sarna ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lumbar Spine ◽  
Bone Loss ◽  
Femoral Neck ◽  
Cancer Patients ◽  
Skeletal Metastases ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Mineral Density ◽  
Premenopausal Breast Cancer

PURPOSE In the majority of premenopausal breast cancer patients, an adjuvant chemotherapy-induced early menopause occurs, which is known to be a strong predictor of osteoporosis. We present data on the effect of adjuvant cyclophosphamide, methotrexate, and fluorouracil (CMF) therapy on bone mineral density (BMD) and the efficacy of clodronate on the prevention of bone loss in 148 premenopausal breast cancer patients without skeletal metastases. MATERIALS AND METHODS Patients were randomized to receive oral clodronate 1,600 mg/d or to a control group. In addition, patients were treated with six cycles of CMF therapy. BMD of the lumbar spine and femoral neck was measured by dual-energy x-ray absorptiometry (DEXA) before therapy and at 1 and 2 years. RESULTS Changes in the BMD of lumbar spine and femoral neck were -5.9% and -2.0% without clodronate and -2.2% and +0.9% with clodronate at 2 years (P = .0005 and .017, respectively). Patients who developed amenorrhea after chemotherapy had a rapid bone loss, which was significantly reduced by clodronate. In controls, bone loss was 9.5% in the lumbar spine and 4.6% in the femoral neck, while in the clodronate group, bone loss was 5.9% and 0.4%, respectively, at 2 years. Patients with preserved menstruation had only marginal changes in BMD. CONCLUSION Chemotherapy-induced ovarian failure causes rapid bone loss in premenopausal breast cancer patients. Women older than 40 years are at particularly high risk. Clodronate significantly reduces this bone loss.

Brisk Walking Reduces Calcaneal Bone Loss in Post-Menopausal Women

1997 ◽  
Vol 92 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Katherine Brooke-Wavell ◽  
Peter R. M. Jones ◽  
Adrianne E. Hardman
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Loss ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Brisk Walking ◽  
Mineral Density ◽  
Control Subjects ◽  
Menopausal Women ◽  
Post Menopausal

1. This study examined the influence of brisk walking on skeletal status in post-menopausal women. 2. Subjects were 84 healthy women aged 60–70 years who were previously sedentary and at least 5 years post-menopausal. Subjects were randomly assigned to walking (n = 43) and control (n = 41) groups. Walkers followed a 12-month, largely unsupervised programme of brisk walking. The bone mineral density of the lumbar spine, femoral neck and calcaneus and broadband ultrasonic attention of the calcaneus were measured at baseline and after 12 months. 3. Forty control subjects and 38 walkers completed the study. Walkers built up to 20.4 ± 3.8 min/day (mean ± SD) of brisk walking. Body mass increased in control subjects relative to walkers [mean change (SE) ± 0.9 (0.3) and −0.1 (0.3) kg respectively; P = 0.04]. Predicted maximum oxygen uptake increased in walkers by 2.1 (0.9) ml min−1 kg−1 (P = 0.02). Bone mineral density in the lumbar spine and calcaneus fell in control subjects [–0.005 (0.004) and −0.010 (0.004) g/cm2, respectively] but not in walkers [+0.006 (0.004) and +0.001 (0.004) g/cm2]. The difference in response between groups was significant in the calcaneus (P = 0.04) but not in the lumbar spine (P = 0.08). Mean femoral neck bone mineral density did not change significantly in either group, although changes in walkers were related to the amount of walking completed (r = 0.51, P = 0.001). The change in broadband ultrasonic attenuation of the calcaneus differed between groups [control subjects, −3.7 (0.8); walkers, −0.7 (0.8) dB/MHz; P = 0.01]. 4. Walking decreased bone loss in the calcaneus and possibly in the lumbar spine. It also improved functional capacity and enabled walkers to avoid the increase in body mass seen in control subjects.

RELATIONSHIP BETWEEN SERUM OC AND SCTX WITH BONE MINERAL DENSITY IN PREDICTING BONE LOSS AND TREATING FOR POSTMENOPAUSAL OSTEOPOROSIS WOMEN OVER 45 YEARS OLD WITH FOSAMAX PLUS THERAPY

2017 ◽  
pp. 126-231
Author(s):  
Van Duc Tran ◽  
Van An Le ◽  
Hai Thuy Nguyen
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Loss ◽  
Prospective Study ◽  
Key Words ◽  
Postmenopausal Osteoporosis ◽  
Negative Correlation ◽  
Mineral Density ◽  
Cross Sectional ◽  
Femur Neck

Backgrounds: Serum OC and ssCTX are correlated with BMD and have early changes under antiresorptive therapies. This study was aimed to find correlations between serum OC, sCTX and BMD changes in women over 45 and evaluated early changes of the two markers in postmenopausal osteoporotic women with Fosamax plus therapy. Materials and Methods: Cross-sectional and prospective study. 142 women over 45 were tested for serum OC and sCTX and determined BMD at lumbar spine and femur neck. 37 postmenopausal osteoporotic women of the group were treated with Fosamax plus therapy. Results: OC and sCTX showed negative correlation with BMD of lumbar spine and femur neck in all of women over 45. The correlation between sCTX and BMD of femur neck was not significant. The lowest values of OC and sCTX to predict bone loss in non-osteoporotic women were 14.46ng/ml (ss = 76.1%, sp = 40%) and 396.25pg/ml (ss = 66%, sp = 52%). The decreasing rates of serum OC and sCTX after 3 and 6 months with Fosamax plus therapy were 41.6%, 55% (p ˂ 0.0001) and 78.3%, 72% (p ˂ 0.0001), respectively. Slow increasing rates of BMD at two sites were 4.2% (p ˂ 0.001) and 3.6% (p ˃ 0.05), irrespectively. Conclusions: OC and sCTX were inversely correlated to BMD of lumbar spine and femur neck in all of women over 45. The lowest values of OC and sCTX to predict bone loss in non-osteoporotic women were 14.46ng/ml and 396.25pg/ml. Serum OC và sCTX decreased early in comparision to BMD improvement in postmenopausal osteoporotic women with Fosamax plus therapy. Key words: oC, sCTX, postmenopausal osteoporotic women, Fosamax plus

scholarly journals High Bone Mineral Density of the Lumbar Spine Is Positively Associated with Breast Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Larissa Vaz Gonçalves ◽  
Karine Anusca Martins ◽  
Jordana Carolina Marques Godinho-Mota ◽  
Raquel Machado Schincaglia ◽  
Ana Luisa Lima Sousa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Menopausal Status ◽  
Total Sample ◽  
University Hospital ◽  
High Bone Mineral Density ◽  
Mineral Density

Objective. The objective of this study was to verify possible associations between bone mineral density (BMD) and breast cancer in recently diagnosed women in the Brazilian Mid-west region, considering the menopausal status of patients. Methods. A case-control study was conducted with 142 cases of breast cancer and 234 controls matched by for age, body mass index (BMI), and menopausal status (pre- and postmenopause), performed in a university hospital in the Brazilian Mid-west. Lumbar spine (L1–L4), femoral neck, and total femur BMD were measured by the dual-energy X-ray absorptiometry (DXA) method. For association, a logistic regression analysis was used. Results. Women in the highest lumbar spine BMD quartile presented had a higher chance of developing breast cancer (OR = 2.31; 1.02–5.25; p = 0.045), after adjusting for the confounding variables. Nonetheless, there were no statistically significant differences in the association between pre- and postmenopause in that quartile and breast cancer. Conclusions. High lumbar spine BMD was positively associated with breast cancer in the total sample. In evaluating the BMD of the femoral neck and total femur, such an association was not observed.

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