The tamoxifen paradox-influence of adjuvant tamoxifen on fracture risk in pre- and postmenopausal women with breast cancer.

Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
I KyvernitakisP Hadji

Abstract

Our data demonstrate that tamoxifen does not reduce fracture risk. Close surveillance is necessary to prevent bone loss in premenopausal women with breast cancer upon treatment initiation. Endocrine treatment of breast cancer may interfere with bone turnover and influence fracture risk. Out of a cohort of almost 5 million patients in total, we identified 5520 women between 18 and 90 years of age with breast cancer receiving tamoxifen, matched them with 5520 healthy controls using the Disease Analyzer Database, and investigated the fracture risk. We found a cumulative incidence of fractures of 6.3% in patients aged between 18 and 50 years (n = 3634) treated with tamoxifen versus a cumulative incidence of 3.6% in the control group (p < 0.001). As such, the risk of fracture was 75% higher for patients receiving tamoxifen than that for healthy controls (HR 1.75; 95% CI 1.25-2.48). With regard to patients aged between 55 and 90 years (n = 7406), the cumulative incidence of fractures in patients treated with tamoxifen was 10.1% compared to 9.3% in the control group (p = 0.740), i.e., there was no significant difference between the two groups (HR 0.97; 95% CI 0.81-1.16). Compared to healthy controls, premenopausal women with breast ca...Continue Reading

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Citations

May 27, 2020·The Journal of Clinical Endocrinology and Metabolism·Jessica PepeSerge Ferrari
Aug 24, 2019·Journal of Bone Oncology·Ulla StumpfPeyman Hadji
Jan 23, 2021·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Darya DudenkoAntonio Cano
Feb 19, 2021·Molecular and Cellular Biochemistry·Deborah MolehinKevin Pruitt
May 27, 2021·Climacteric : the Journal of the International Menopause Society·M Conradie, T de Villiers
Jul 9, 2021·Calcified Tissue International·Outi Mäkitie, M Carola Zillikens

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