Postmenopausal breast cancer survivors at increased risk for bone fractures

March 14, 2005

CHICAGO - Postmenopausal breast cancer survivors may be at increased risk for fractures (except for the hip) compared with other women in the same age group, according to an article in the March 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Previous small studies have found low bone density among postmenopausal breast cancer survivors and accelerated bone loss after chemotherapy for breast cancer suggesting an increased risk for fractures among breast cancer survivors, according to background information in the article. Previous studies on the risk of fractures have been inconsistent.

Zhao Chen, Ph.D., M.P.H., of the University of Arizona, Tucson, and colleagues, using data from the Women's Health Initiative (WHI) Observational Study (WHI-OS), compared the occurrence of bone fractures over the course of 5.1 years in 5,298 women who reported a history of breast cancer with a reference group of 80,848 women who had no cancer history. Women reported annually in questionnaires on fractures that had been diagnosed by a physician; the fractures were categorized into four groups: hip; forearm/wrist; clinical vertebral (spine or back); and other clinical fractures.

"Using the age distribution of the entire WHI-OS cohort, we computed age-standardized fracture rates per 10,000 person-years [number of persons times number of years of observation] for breast cancer survivors and the reference group," the authors write. "Except for the hip fracture rate, fracture rates were higher in the breast cancer survivors than in the reference group. Overall, breast cancer survivors may sustain 68.6 excess fractures per 10,000 person-years compared with other women in the same age group."

The increased risk for total fractures among breast cancer survivors persisted even after adjustment for other risk factors, including fracture history lifestyle, medication use and the use of hormonal replacement therapy, the researchers found. Other factors, including age, ethnicity and depression, were associated with increased risk of fractures among breast cancer survivors. "An increased risk for total fractures was observed in all ages of breast cancer survivors in this study regardless of the time of the breast cancer diagnosis," the researchers state.

"In summary, we found increased fracture risks among breast cancer survivors," the authors conclude. "If our study results are confirmed by others, the excess number of fractures may be as high as 13,000 per year for the two million postmenopausal breast cancer survivors in the United States. Clearly, more research is needed to understand the fracture risk in this special population and to develop strategies to reduce the number of fractures among breast cancer survivors."
-end-
(Arch Intern Med. 2005; 165:552-558. Available post-embargo at www.archinternmed.com.)

Editor's Note: Co-author Margery Gass, M.D., has performed clinical research with Wyeth, Lilly, Pfizer and Proctor and Gamble. This study was supported by The National Institutes of Health contracts for Women's Health Initiative Clinical Centers and Clinical Coordinating Center. Dr. Zhao Chen was supported by an award from the National Institute of Arthritis, Musculoskeletal, and Skin Diseases, Bethesda, Md.

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or email mediarelations@jama-archives.org.

The JAMA Network Journals

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.