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Clinical Pearl: Osteoporosis and breast cancer
Bone health is of paramount importance for patients undergoing aromatase inhibitor (AI) therapy for breast cancer. While endocrine treatments improve cancer-specific outcomes, they may cause severe hypogonadism leading to accelerated bone loss.
Osteoperosis is common in women and men over 50 years of age
The latest Australian guidelines recommend that all women undergoing AI therapy for breast cancer have a baseline assessment of fracture risk prior to commencing therapy.
Assessment includes review of clinical risk factors, basic laboratory testing, and hip and spine bone mineral density measurement by dual-energy X-ray absorptiometry (DXA).
It is important to remember that risk calculators such as the Garvan Fracture Risk Calculator and FRAX do not take AI use into account and may substantially underestimate fracture risk.
In addition to a baseline assessment, general bone health maintenance measures to prevent bone loss should be implemented in all women commencing AI therapy.
Visit the new RACGP's Osteoporosis prevention, diagnosis and management in postmenopausal women and men over 50 years of age (2nd edition) for more information, including the clinical risk factors for osteoporosis in breast cancer.
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