Incidence of fractures in young women with breast cancer - a retrospective cohort study
In recent years, cancer treatment-induced bone loss (CTIBL) and increased risk of fracture has become an emerging problem as breast cancer (BC) survival has increased due to early diagnosis and improved treatments. In premenopausal women with BC, chemotherapy and tamoxifen are the treatments of choi...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-10-01
|
| Series: | Journal of Bone Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212137419301459 |
| _version_ | 1828864688636559360 |
|---|---|
| author | Ulla Stumpf Karel Kostev Iannis Kyvernitakis Wolfgang Böcker Peyman Hadji |
| author_facet | Ulla Stumpf Karel Kostev Iannis Kyvernitakis Wolfgang Böcker Peyman Hadji |
| author_sort | Ulla Stumpf |
| collection | DOAJ |
| description | In recent years, cancer treatment-induced bone loss (CTIBL) and increased risk of fracture has become an emerging problem as breast cancer (BC) survival has increased due to early diagnosis and improved treatments. In premenopausal women with BC, chemotherapy and tamoxifen are the treatments of choice in hormone receptor-negative and hormone receptor-positive BC respectively. Their effect on fracture risk has only been investigated in a few small-scale studies.Therefore, we investigated the fracture risk in a cohort study based on data from the Disease Analyzer database (IQVIA) and included 1761 individuals with BC and 1761 healthy women for comparison. After applying similar inclusion criteria, patients with BC were matched 1:1 to those without BC with regard to age, index year, and physician. Within 10 years of the index date, 6.4% of healthy women and 14.2% with BC sustained a fracture (log-rank p-value < 0.001), showing a positive association between breast cancer and fractures (adjusted hazard ratio (HR)=2.39, p < 0.001). When analyzing women with BC with and without tamoxifen treatment, 14.7% with and 12.9% without tamoxifen sustained a fracture. However, after adjustment, the HR was 2.58 (p < 0.001) for women on tamoxifen versus healthy women and 1.63 (p = 0.181) for women with BC without tamoxifen treatment versus healthy women.In conclusion, premenopausal women with BC with or without tamoxifen treatment had an increased incidence of fractures compared to healthy women, but this difference was only significant when comparing tamoxifen users versus healthy women. More studies are needed to identify the specific risk factors of women at high risk. Keywords: Breast cancer, Fracture, Chemotherapy, Osteoporosis, Tamoxifen, Premenopausal women |
| first_indexed | 2024-12-13T04:11:49Z |
| format | Article |
| id | doaj.art-4e14725e6a2943c79fdc1464e8e89863 |
| institution | Directory Open Access Journal |
| issn | 2212-1374 |
| language | English |
| last_indexed | 2024-12-13T04:11:49Z |
| publishDate | 2019-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Bone Oncology |
| spelling | doaj.art-4e14725e6a2943c79fdc1464e8e898632022-12-22T00:00:01ZengElsevierJournal of Bone Oncology2212-13742019-10-0118Incidence of fractures in young women with breast cancer - a retrospective cohort studyUlla Stumpf0Karel Kostev1Iannis Kyvernitakis2Wolfgang Böcker3Peyman Hadji4Department of General, Trauma and Reconstructive Surgery, Munich University Hospital LMU, Munich, GermanyEpidemiology, IQVIA, Main Airport Center, Unterschweinstiege 2-14, Frankfurt am Main 60549, Germany; Corresponding author.Bürgerhospital Frankfurt, Frauenklinik – Zentrum für Ultraschalldiagnostik und Pränatalmedizin and Philipps-University of Marburg, GermanyDepartment of General, Trauma and Reconstructive Surgery, Munich University Hospital LMU, Munich, GermanyFrankfurt Centre of Bone Health and Philips-University of Marburg, GermanyIn recent years, cancer treatment-induced bone loss (CTIBL) and increased risk of fracture has become an emerging problem as breast cancer (BC) survival has increased due to early diagnosis and improved treatments. In premenopausal women with BC, chemotherapy and tamoxifen are the treatments of choice in hormone receptor-negative and hormone receptor-positive BC respectively. Their effect on fracture risk has only been investigated in a few small-scale studies.Therefore, we investigated the fracture risk in a cohort study based on data from the Disease Analyzer database (IQVIA) and included 1761 individuals with BC and 1761 healthy women for comparison. After applying similar inclusion criteria, patients with BC were matched 1:1 to those without BC with regard to age, index year, and physician. Within 10 years of the index date, 6.4% of healthy women and 14.2% with BC sustained a fracture (log-rank p-value < 0.001), showing a positive association between breast cancer and fractures (adjusted hazard ratio (HR)=2.39, p < 0.001). When analyzing women with BC with and without tamoxifen treatment, 14.7% with and 12.9% without tamoxifen sustained a fracture. However, after adjustment, the HR was 2.58 (p < 0.001) for women on tamoxifen versus healthy women and 1.63 (p = 0.181) for women with BC without tamoxifen treatment versus healthy women.In conclusion, premenopausal women with BC with or without tamoxifen treatment had an increased incidence of fractures compared to healthy women, but this difference was only significant when comparing tamoxifen users versus healthy women. More studies are needed to identify the specific risk factors of women at high risk. Keywords: Breast cancer, Fracture, Chemotherapy, Osteoporosis, Tamoxifen, Premenopausal womenhttp://www.sciencedirect.com/science/article/pii/S2212137419301459 |
| spellingShingle | Ulla Stumpf Karel Kostev Iannis Kyvernitakis Wolfgang Böcker Peyman Hadji Incidence of fractures in young women with breast cancer - a retrospective cohort study Journal of Bone Oncology |
| title | Incidence of fractures in young women with breast cancer - a retrospective cohort study |
| title_full | Incidence of fractures in young women with breast cancer - a retrospective cohort study |
| title_fullStr | Incidence of fractures in young women with breast cancer - a retrospective cohort study |
| title_full_unstemmed | Incidence of fractures in young women with breast cancer - a retrospective cohort study |
| title_short | Incidence of fractures in young women with breast cancer - a retrospective cohort study |
| title_sort | incidence of fractures in young women with breast cancer a retrospective cohort study |
| url | http://www.sciencedirect.com/science/article/pii/S2212137419301459 |
| work_keys_str_mv | AT ullastumpf incidenceoffracturesinyoungwomenwithbreastcanceraretrospectivecohortstudy AT karelkostev incidenceoffracturesinyoungwomenwithbreastcanceraretrospectivecohortstudy AT ianniskyvernitakis incidenceoffracturesinyoungwomenwithbreastcanceraretrospectivecohortstudy AT wolfgangbocker incidenceoffracturesinyoungwomenwithbreastcanceraretrospectivecohortstudy AT peymanhadji incidenceoffracturesinyoungwomenwithbreastcanceraretrospectivecohortstudy |