乳腺癌芳香化酶抑制剂治疗期间骨丢失的长期随访结果.

Objective To evaluate the bone loss of postmenopausal early-stage breast cancer in Chinese patients during 5-year aromatase inhibitor (AI) adjuvant endocrine therapy and to provide the basis for bone health management. Methods The study was a prospective observational study. Patients with estrogen receptor (ER) and /or progesterone receptor (PR) positive postmenopausal early breast cancer had to take an examination for bone mineral density (BMD) before starting AI adjuvant endocrine therapy. BMD of the femoral neck, total hip, and the lumbar spine was detected using dual-energy X-ray absorptiometry. During the treatment, patients needed to receive BMD annually and were followed up regularly. The changes of BMD and the incidence of osteoporosis during AI treatment were analyzed. Results From November 2013 to August 2016, 131 patients with breast cancer meeting the inclusion criteria were enrolled. Their median age was 60 years old, median menopausal age was 50, and the treatment time of AI was 60 to 100 months. With a median follow-up of 86 months, BMD of the lumbar spine L1 to L4, femoral neck, and total hip decreased year by year during the 5-year AI treatment. The total BMD decrease rate in 5 years was 6.90%, 5.68%, and 7.14%, respectively. BMD decreased most rapidly in the first year and decreased steadily from 2 to 5 years. The change rate of lumbar spine BMD in the first year was significantly higher than that from 2 to 5 years (P<0.01). Further stratified analysis showed that baseline BMD, age, and BMI did not affect the decreasing rate of BMD. Seventeen patients (17%) had new-onset osteoporosis during the 5 years, including 15 patients with baseline bone mass loss, 76% of whom occurred in the lumbar spine (13/17), and the fracture incidence was 2% (2/100). Conclusion BMD in postmenopausal early breast cancer patients decreases year by year during the AI adjuvant endocrine therapy. Bone health management during AI treatment should be strengthened and early intervention should be taken to reduce the occurrence of osteoporosis. [ABSTRACT FROM AUTHOR]