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Aromatase inhibitor-associated bone loss in breast cancer patients is distinct from postmenopausal osteoporosis  Peyman Hadji  Critical Reviews in Oncology.

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Presentation on theme: "Aromatase inhibitor-associated bone loss in breast cancer patients is distinct from postmenopausal osteoporosis  Peyman Hadji  Critical Reviews in Oncology."— Presentation transcript:

1 Aromatase inhibitor-associated bone loss in breast cancer patients is distinct from postmenopausal osteoporosis  Peyman Hadji  Critical Reviews in Oncology / Hematology  Volume 69, Issue 1, Pages (January 2009) DOI: /j.critrevonc Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

2 Fig. 1 Risk of bone fracture correlates with undetectable estrogen levels. Shown are baseline serum estradiol concentrations and age-adjusted risk of hip or spine fracture. Reprinted with permission from Cummings et al. [7]. Copyright© 1998, Massachusetts Medical Society. All rights reserved. Critical Reviews in Oncology / Hematology  , 73-82DOI: ( /j.critrevonc ) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

3 Fig. 2 Aromatase inhibitor-induced bone loss (AIBL) exceeds normal postmenopausal bone loss. Annual bone loss is shown for premenopausal women, postmenopausal women, and postmenopausal women with breast cancer (BC) receiving aromatase inhibitor (AI) therapy. Data from *Warming et al. [31]; †Lindsey et al. [32]; and ‡Eastell et al. [27]. Critical Reviews in Oncology / Hematology  , 73-82DOI: ( /j.critrevonc ) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

4 Fig. 3 (A) Bone mineral density (BMD) loss and (B) fracture incidence are accelerated in women with breast cancer (BC) receiving aromatase inhibitor (AI) therapy compared with a normal postmenopausal woman (PMW). The shaded areas between the dotted lines on the graphs represent hypothetical rates of bone loss and fracture incidence after 5 years of AI therapy based on rates seen in women with BC receiving AIs and normal PMW. Data from *Warming et al. [31] and Lindsey et al. [32]; †Eastell et al. (estimate based on average of year 1 and year 2 data) [27]; ‡Howell et al. [13]; and §Kanis et al. [39]; ?hypothetical. Critical Reviews in Oncology / Hematology  , 73-82DOI: ( /j.critrevonc ) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

5 Fig. 4 Most fractures occur in women with normal or osteopenic bone mineral density (BMD). Shown are bone mineral density, osteoporotic fracture rate, and the number of women with fractures. Reprinted with permission from Siris et al. [45]. Copyright© 2004, American Medical Association. All rights reserved. Critical Reviews in Oncology / Hematology  , 73-82DOI: ( /j.critrevonc ) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

6 Fig. 5 Upfront zoledronic acid prevents aromatase inhibitor associated bone loss in postmenopausal women with breast cancer. Mean (standard error of the mean) percentage change in bone mineral density of the lumbar spine and the total hip at months 6 and 12 in women with early-stage breast cancer administered upfront or delayed zoledronic acid are shown; *p-Values correspond to intragroup comparisons from baseline to month 12. Reprinted from Brufsky et al. [25]. Reprinted with permission of the American Society of Clinical Oncology. Critical Reviews in Oncology / Hematology  , 73-82DOI: ( /j.critrevonc ) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions

7 Fig. 6 Upfront zoledronic acid prevents tamoxifen and aromatase inhibitor associated bone loss in premenopausal women with breast cancer receiving endocrine therapy. Shown are changes from baseline T-scores over time in the lumbar spine of patients treated for 36 months with anastrozole or tamoxifen±zoledronic acid. All patients received goserelin. Reprinted from Gnant et al. [28]. Reprinted with permission of the American Society of Clinical Oncology. Critical Reviews in Oncology / Hematology  , 73-82DOI: ( /j.critrevonc ) Copyright © 2008 Elsevier Ireland Ltd Terms and Conditions


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