scholarly journals Assessment and management of bone health in women with oestrogen receptor-positive breast cancer receiving endocrine therapy: Position statement of the Endocrine Society of Australia, the Australian and New Zealand Bone & Mineral Society, the Australasian

2018 ◽  
Vol 89 (3) ◽  
pp. 280-296 ◽  
Author(s):  
Mathis Grossmann ◽  
Sabashini K. Ramchand ◽  
Frances Milat ◽  
Amanda Vincent ◽  
Elgene Lim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
New Zealand ◽  
Endocrine Therapy ◽  
Bone Mineral ◽  
Bone Health ◽  
Oestrogen Receptor ◽  
Position Statement ◽  
Endocrine Society ◽  
Mineral Society ◽  
Positive Breast Cancer

scholarly journals Assessment and management of bone health in women with oestrogen receptor‐positive breast cancer receiving endocrine therapy: position statement summary

2019 ◽  
Vol 211 (5) ◽  
pp. 224-229 ◽  
Author(s):  
Mathis Grossmann ◽  
Sabashini K Ramchand ◽  
Frances Milat ◽  
Amanda Vincent ◽  
Elgene Lim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Bone Health ◽  
Oestrogen Receptor ◽  
Position Statement ◽  
Positive Breast Cancer

scholarly journals Calcium and bone health: position statement for the Australian and New Zealand Bone and Mineral Society, Osteoporosis Australia and the Endocrine Society of Australia

2009 ◽  
Vol 190 (6) ◽  
pp. 316-320 ◽  
Author(s):  
Kerrie M Sanders ◽  
Caryl A Nowson ◽  
Mark A Kotowicz ◽  
Kathryn Briffa ◽  
Amanda Devine ◽  
...  
Keyword(s):  
New Zealand ◽  
Bone Health ◽  
Position Statement ◽  
Endocrine Society ◽  
Mineral Society

scholarly journals Identifying Biomarkers to Select Patients with Early Breast Cancer Suitable for Extended Adjuvant Endocrine Therapy

Breast Care ◽  
2017 ◽  
Vol 12 (3) ◽  
pp. 146-151 ◽  
Author(s):  
Ivana Sestak
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Oestrogen Receptor ◽  
Clinical Information ◽  
Late Recurrence ◽  
Correct Identification ◽  
Breast Cancer Therapy ◽  
Increased Risk ◽  
Extended Endocrine Therapy ◽  
Positive Breast Cancer

Postmenopausal women with early oestrogen receptor-positive breast cancer who have received 5 years of endocrine therapy are at increased risk of developing a recurrence. An important clinical question is how to identify women who are at highest (or lowest) risk of a recurrence. The use of prognostic biomarkers allows individualised breast cancer therapy but correct identification of patients who will benefit most from extended endocrine therapy is essential. Several multigene assays have been developed to determine the likelihood of overall recurrence but so far none exist specifically for the prediction of late recurrence. Recent results from large clinical trials have shown that biomarker assays that include clinical information in their tests might be useful to predict and risk stratify patients for late recurrence. However, further research is needed to specifically offer multigene assays for the identification of late recurrence and thus justify routine use of these tests in the clinical setting.

Evaluating bone health in women with oestrogen receptor positive breast cancer (ERBC) starting aromatase inhibitors

2009 ◽  
Vol 35 (5) ◽  
pp. 475-480 ◽  
Author(s):  
G.P. Clunie ◽  
A. Clark ◽  
C.J. Mortimer ◽  
S. Stephenson ◽  
J. Aitken ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Aromatase Inhibitors ◽  
Bone Health ◽  
Oestrogen Receptor ◽  
Positive Breast Cancer

scholarly journals The effects of adjuvant endocrine therapy on bone health in women with breast cancer

2019 ◽  
Vol 241 (3) ◽  
pp. R111-R124 ◽  
Author(s):  
Sabashini K Ramchand ◽  
Yee-Ming Cheung ◽  
Belinda Yeo ◽  
Mathis Grossmann
Keyword(s):  
Breast Cancer ◽  
Fracture Risk ◽  
Postmenopausal Women ◽  
Endocrine Therapy ◽  
Aromatase Inhibitors ◽  
Bone Health ◽  
Oestrogen Receptor ◽  
Breast Tissue ◽  
Premenopausal Women ◽  
Er Positive

In women with oestrogen receptor (ER)-positive early breast cancer, oestradiol is important for breast cancer development and progression. Endocrine therapy prevents the deleterious effects of oestradiol in breast tissue by systemically depleting oestradiol concentration (aromatase inhibitors) or preventing its local action in breast tissue (selective oestrogen receptor modulators i.e. tamoxifen), thereby improving oncological outcomes. Use of aromatase inhibitors in postmenopausal women and ovarian function suppression with either tamoxifen or aromatase inhibition in premenopausal women, consequent to systemic oestradiol depletion, exerts detrimental effects on skeletal health. The oestradiol-deficient state causes increased bone remodelling and a negative bone balance. This results in bone loss, microstructural deterioration and bone fragility predisposing to fractures. Similar effects are also seen with tamoxifen in premenopausal women. In contrast, use of tamoxifen in postmenopausal women appears to exert protective effects on bone but studies on fracture risk are inconclusive. The longevity of women with ER-positive breast cancer treated with adjuvant endocrine therapy emphasises the need to mitigate the adverse skeletal effects of these therapies in order to maximise benefit. In general, fractures are associated with increased morbidity, mortality and are a high socioeconomic burden. Whilst the efficacy of antiresorptive therapy in preventing bone mineral density loss in postmenopausal women has been established, further clinical trial evidence is required to provide guidance regarding fracture risk reduction, when to initiate and stop treatment, choice of agent and optimal management of bone health in premenopausal women receiving endocrine therapy. In addition, potential oncological benefits of antiresorptive therapies will also need to be considered.

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