High prevalence of vertebral fractures in women with breast cancer starting aromatase inhibitor therapy

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Bouvard, Béatrice | Hoppé, Emmanuel | Soulié, P. | Georgin-Mege, Martine | Jadaud, E. | Abadie-Lacourtoisie, S. | Petit, Audrey | Laffitte, A. | Levasseur, R. | Audran, Maurice | Chappard, Daniel | Legrand, Erick

Edité par CCSD ; Elsevier -

International audience.

Background: The purpose of this study was to describe bone status in a large cohort of postmenopausal women with nonmetastatic breast cancer, at the initiation of aromatase inhibitor therapy.Patients and methods: A prospective, transversal and clinical study was conducted. Each woman had an extensive medical history, a biological evaluation, a bone mineral density (BMD) measurement and spinal X-rays. Results: Four hundred and ninety-seven women aged 63.8 ± 9.6 years were included in this study. Eighty-five percent of these women had a 25-OH vitamin D concentration <75 nmol/l. One hundred and fifty-six women (31.4%) had a T-score < −2 at one of the three site measurements. Ninety-five women (19.1%) had a history of nonvertebral fracture with a total of 120 fractures. Spine X-rays evaluation revealed that 20% of the women had at least one vertebral fracture. The presence of vertebral fracture was associated with nonvertebral fracture history [odds ratio (OR) 1.6, 95% confidence interval (CI) 1.1–2.4] and with spine BMD (OR 1.4, 95% CI 1.1–1.7). The prevalence of vertebral fracture reached 62.9% in women with age above 70 years and femoral T-score < −2.5. Conclusion: Before starting aromatase inhibitor therapy for breast cancer, a large proportion of women had a vitamin D insufficiency and vertebral fractures.

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