Assessment and management of bone health in women with oestrogen receptor-positive breast cancer receiving endocrine therapy: position statement summary.
Breast neoplasms
Osteoporosis
Journal
The Medical journal of Australia
ISSN: 1326-5377
Titre abrégé: Med J Aust
Pays: Australia
ID NLM: 0400714
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
pubmed:
19
7
2019
medline:
23
2
2020
entrez:
19
7
2019
Statut:
ppublish
Résumé
Representatives appointed by relevant Australian medical societies used a systematic approach for adaptation of guidelines (ADAPTE) to formulate clinical consensus recommendations on assessment and management of bone health in women with oestrogen receptor-positive early breast cancer receiving endocrine therapy. The current evidence suggests that women receiving adjuvant aromatase inhibitors and pre-menopausal woman treated with tamoxifen have accelerated bone loss and that women receiving adjuvant aromatase inhibitors have increased fracture risk. Both bisphosphonates and denosumab prevent bone loss; additionally, denosumab has proven anti-fracture benefit in post-menopausal women receiving aromatase inhibitors for hormone receptor-positive breast cancer. Women considering endocrine therapy need fracture risk assessment, including clinical risk factors, biochemistry and bone mineral density measurement, with monitoring based on risk factors. Weight-bearing exercise and vitamin D and calcium sufficiency are recommended routinely. Anti-resorptive treatment is indicated in women with prevalent or incident clinical or morphometric fragility fractures, and should be considered in women with a T score (or Z score in women aged < 50 years) of < - 2.0 at any site, or if annual bone loss is ≥ 5%, considering baseline bone mineral density and other fracture risk factors. Duration of anti-resorptive treatment can be individualised based on absolute fracture risk. Relative to their skeletal benefits, risks of adverse events with anti-resorptive treatments are low. Skeletal health should be considered in the decision-making process regarding choice and duration of endocrine therapy. Before and during endocrine therapy, skeletal health should be assessed regularly, optimised by non-pharmacological intervention and, where indicated, anti-resorptive treatment, in an individualised, multidisciplinary approach.
Substances chimiques
Aromatase Inhibitors
0
Bone Density Conservation Agents
0
Receptors, Estrogen
0
Vitamin D
1406-16-2
Types de publication
Journal Article
Practice Guideline
Langues
eng
Sous-ensembles de citation
IM
Pagination
224-229Informations de copyright
© 2019 AMPCo Pty Ltd.
Références
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