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Osteoporosis and rate of bone loss among postmenopausal survivors of breast cancer†
Results from a subgroup in the Women's Health Initiative Observational Study
Version of Record online: 18 AUG 2005
Copyright © 2005 American Cancer Society
Volume 104, Issue 7, pages 1520–1530, 1 October 2005
How to Cite
Chen, Z., Maricic, M., Pettinger, M., Ritenbaugh, C., Lopez, A. M., Barad, D. H., Gass, M., LeBoff, M. S. and Bassford, T. L. (2005), Osteoporosis and rate of bone loss among postmenopausal survivors of breast cancer. Cancer, 104: 1520–1530. doi: 10.1002/cncr.21335
Short list of Women's Health Initiative investigators:
Program Office (National Heart, Lung, and Blood Institute, Bethesda, Maryland): Barbara Alving, Jacques Rossouw, Linda Pottern.
Clinical Coordinating Center (Fred Hutchinson Cancer Research Center, Seattle, WA) Ross Prentice, Garnet Anderson, Andrea LaCroix, Ruth E. Patterson, Anne McTiernan; (Wake Forest University School of Medicine, Winston-Salem, NC) Sally Shumaker, Pentti Rautaharju; (Medical Research Labs, Highland Heights, KY) Evan Stein; (University of California at San Francisco, San Francisco, CA) Steven Cummings; (University of Minnesota, Minneapolis, MN) John Himes; (University of Washington, Seattle, WA) Bruce Psaty.
Clinical Centers: (Albert Einstein College of Medicine, Bronx, NY) Sylvia Wassertheil-Smoller; (Baylor College of Medicine, Houston, TX) Jennifer Hays; (Brigham and Women's Hospital, Harvard Medical School, Boston, MA) JoAnn Manson; (Brown University, Providence, RI) Annlouise R. Assaf; (Emory University, Atlanta, GA) Lawrence Phillips; (Fred Hutchinson Cancer Research Center, Seattle, WA) Shirley Beresford; (George Washington University Medical Center, Washington, DC) Judith Hsia; (Harbor-UCLA Research and Education Institute, Torrance, CA) Rowan Chlebowski; (Kaiser Permanente Center for Health Research, Portland, OR)Evelyn Whitlock; (Kaiser Permanente Division of Research, Oakland, CA) Bette Caan; (Medical College of Wisconsin, Milwaukee, WI) Jane Morley Kotchen; (MedStar Research Institute/Howard University, Washington, DC) Barbara V. Howard; (Northwestern University, Chicago/Evanston, IL) Linda Van Horn; (Rush-Presbyterian St. Luke's Medical Center, Chicago, IL) Henry Black; (Stanford Center for Research in Disease Prevention, Stanford University, Stanford, CA) Marcia L. Stefanick; (State University of New York at Stony Brook, Stony Brook, NY) Dorothy Lane; (The Ohio State University, Columbus, OH) Rebecca Jackson; (University of Alabama at Birmingham, Birmingham, AL) Cora Beth Lewis; (University of Arizona, Tucson/Phoenix, AZ) Tamsen Bassford; (University at Buffalo, Buffalo, NY) Jean Wactawski-Wende; (University of California at Davis, Sacramento, CA) John Robbins; (University of California at Irvine, Orange, CA) Allan Hubbell; (University of California at Los Angeles, Los Angeles, CA) Howard Judd; (University of California at San Diego, LaJolla/Chula Vista, CA) Robert D. Langer; (University of Cincinnati, Cincinnati, OH) Margery Gass; (University of Florida, Gainesville/Jacksonville, FL) Marian Limacher; (University of Hawaii, Honolulu, HI) David Curb; (University of Iowa, Iowa City/Davenport, IA) Robert Wallace; (University of Massachusetts/Fallon Clinic, Worcester, MA) Judith Ockene; (University of Medicine and Dentistry of New Jersey, Newark, NJ) Norman Lasser; (University of Miami, Miami, FL) Mary Jo O'Sullivan; (University of Minnesota, Minneapolis, MN) Karen Margolis; (University of Nevada, Reno, NV) Robert Brunner; (University of North Carolina, Chapel Hill, NC) Gerardo Heiss; (University of Pittsburgh, Pittsburgh, PA) Lewis Kuller; (University of Tennessee, Memphis, TN) Karen C. Johnson; (University of Texas Health Science Center, San Antonio, TX) Robert Brzyski; (University of Wisconsin, Madison, WI) Gloria Sarto; (Wake Forest University School of Medicine, Winston-Salem, NC) Denise Bonds; (Wayne State University School of Medicine/Hutzel Hospital, Detroit, MI) Susan Hendrix.
- Issue online: 17 SEP 2005
- Version of Record online: 18 AUG 2005
- Manuscript Accepted: 26 APR 2005
- Manuscript Revised: 1 APR 2005
- Manuscript Received: 28 FEB 2005
- National Heart, Lung and Blood Institute
- United States Department of Health and Human Services
- National Institute of Arthritis. Grant Number: R01 AR049411
- Musculoskeletal and Skin Diseases
- United States Department of Health and Human Services
- Proctor & Gamble Pharmaceuticals
- bone mineral density;
- bone loss;
- breast cancer survivor;
- undiagnosed rate for osteoporosis
Breast cancer diagnosis and treatment may put women at higher risk for osteoporosis in later life.
In a subgroup of participants in the Women's Health Initiative Observational Study, authors of the current study investigated differences in bone mineral density (BMD, measured by dual-energy x-ray absorptiometry) between breast cancer survivors (n = 209) and a noncancer reference group (n = 5759).
In comparison to the reference group, breast cancer survivors had significantly lower total body BMD value (0.989 vs. 1.013 g/cm2, P = 0.001) and total hip BMD value (0.823 vs. 0.845 g/cm2, P = 0.02) at baseline after adjustment for age, race/ethnicity, years since menopause, and clinical center. These lower BMD levels were largely explained by lower usage of hormone therapy (HT) among survivors: after additional statistical adjustment for HT, hip BMD values were 0.834 versus 0.844 g/cm2 (P = 0.26), and total body values were 1.005 versus 1.013 g/cm2 (P = 0.33) for survivors and reference women, respectively. More than 77% of survivors with osteoporosis were undiagnosed by their healthcare providers, and this was similar to the undiagnosed rate in the reference group (85.7%). Longitudinally, breast cancer survivors in this study did not demonstrate an accelerated rate of bone loss compared with the reference population.
Associated with lower HT usage, postmenopausal survivors of breast cancer were more likely to have low BMD in comparison to other women of the same age; and many of these survivors with osteoporosis were undiagnosed. Cancer 2005. © 2005 American Cancer Society.