The Research Question RESEARCH METHOD In younger women ( 65) treated for breast cancer, do tamoxifen and aromatase inhibitor (AI) treatments lead to clinically or statistically significant changes in bone fracture risk? RESEARCH METHOD

What the Researchers Did A systematic review of English-language RCTs and cohort studies of fracture risk Time period: Jan. 1997 to May 2015 Independent reviewers: two Studies included: 16 RCTs and 6 cohort studies Effect size: pooled risk ratios Statistical analysis: random effects & inverse variance method

What the Researchers Found Pooled risk ratio (95% confidence intervals) Tamoxifen vs. Control: 0.95 (0.84 to 1.07) AIs vs. Control: 1.17 (1.07 to 1.28) AI vs. Tam: 1.35 (1.21 to 1.51) Treatment period: 1.33 (1.21 to 1.47) Post-treatment period: 0.99 (0.72 to 1.37)

What This Means for Clinical Practice Younger women (65) who receive tamoxifen breast cancer treatment should be encouraged to have BMD testing as recommended for women who are at the same age and have not been diagnosed with breast cancer Younger women (65) who receive AI breast cancer treatment should be encouraged to have BMD testing as recommended by guidelines. Optimal osteoporosis management programs, especially during the treatment period, are needed for women who receive AI breast cancer treatment