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ADJUVANT (HORMONAL) THERAPY AS A CAUSE OF BONE LOSS IN PATIENTS WITH BREAST CANCER (REVIEW OF LITERATURE)
N Khachidze1, E Giorgadze1, M Tsagareli1
1I. Javakhishvili Tbilisi State University; National Institute of Endocrinology, Tbilisi, Georgia.
Abstract:
Adjuvant (hormonal) therapy is the main method of treatment after surgery in hormone (estrogen and/or progesterone) positive breast cancer patients. The goal of above mentioned treatment is to reduce or block the level of estrogen and progesterone. ultiple clinical trials have revealed that hormonal therapy in breast cancer patients affect bone mineral density (BMD). Authors have analyzed data obtained from several clinical trials conducted in several countries (including Georgia). The final conclusion is that selective estrogen receptor modulators (SERMs) have negative effect on BMD in pre-menopausal women and aromatase inhibitors (anastrozole, letrozole, exemestane) are associated with significant bone loss in post-menopausal women. It is recommended to assess BMD during the adjuvant (hormonal) therapy using Dual Energy X-ray Absorptiometry (DXA). Because of significant negative impact of aromatase inhibitors on BMD, it is suggested to involve antiresorbtive treatment in parallel with hormonal therapy.
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