Evaluation of bone mineral density in postmenopausal breast Cancer survivors

Abstract

Breast cancer is the second most common type of cancer worldwide and the most prevalent among women. Long follow-up is recommended after the diagnosis and treatment of breast cancer and with age the risk of comorbidities increases. Current anticancer strategies have contributed to the increase of cancer survivors and in some cases, cancer becomes a "chronic disease". Studies indicate that breast cancer survivors are at high risk for cardiovascular disease, diabetes, and osteoporosis; admittedly a vulnerable population. Osteoporosis affects more than 200 million people worldwide and is most prevalent in Caucasian women. In the early years postmenopausal, in response to hypoestrogenism, occurs rapid loss of bone mass. The decline in bone mineral density (BMD) and structural integrity results in an increased risk for osteoporosis in women. The major clinical consequence of osteoporosis is a fracture, which occurs mainly in the femoral neck, spine, and wrist. There is a five times higher prevalence of vertebral fractures in breast cancer survivors when compared to women of similar age. The vertebral or hip fractures are associated with a 20% increase in mortality rate. Recognizing the risk for reduced BMD and the consequences on quality of life is imperative a program promotes bone health for breast cancer survivors. The overall objective of the study is to evaluate BMD in postmenopausal breast cancer survivors followed at Botucatu Medical School, UNESP. And the specific objectives are 1 - To study the occurrence of low bone mineral density in postmenopausal breast cancer survivors 2 - to investigate the most influential risk factors for low bone mineral density in breast cancer survivors compared to those without breast cancer. Methods: This is a clinical, analytical, and comparative study. Will be included in the study group women with: (1) date of last menstrual period for at least 12 months and age > 45 years, (2) histological diagnosis of breast cancer, (3) have completed treatment with surgery, radiotherapy, chemotherapy and hormone therapy (when indicated), (4) be free of disease for at least five years, (5) non-alcoholic and non-addicted. The control group in a 1:2 ratio control, will consist of women with last menstrual period for at least 12 months and age >45 years without breast cancer and matched by age. Will be collected through interviews, clinical data regarding osteoporosis risk, anthropometry, DEXA, and, data on breast cancer. It is hoped that the findings can assist in knowledge about the pattern of BMD in this special group of patients and identify women at high risk for osteoporotic fracture assisting in improving follow-up and conduct in clinical practice, affecting significantly the quality of life of postmenopausal breast cancer survivors. (AU)