DEXA scanning for osteoporosis in patients on aromatase inhbitors – pro

Breast cancer patients are at an increased risk of osteoporosis due to age, cancer, chemotherapy, and aromatase inhibitor therapy.  The latter, by depriving the bone of estrogenic stimulation both promotes and accelerates osteoporosis. Because of this, imaging to detect and follow this condition as well as bisphosphonates used to treat osteoporosis,  are standard treatment along with the aromatase inhibitor. Guidelines recommend a baseline DEXA scan within the first three months of starting this therapy and repeated as needed. The UK Consensus Group supports annual Bone Desnity: “Monitoring and treatment thereafter depends on the baseline BMD and the type of any concomitant endocrine treatment. Owing to the very rapid bone loss observed with the use of ovarian suppression therapy plus an aromatase inhibitor, a different threshold for follow-up, monitoring and intervention is recommended.”

Reid DM, Doughty J, Eastell R, Heys SD, Howell A, McCloskey EV, Powles T, Selby P, Coleman RE. Guidance for the management of breast

cancer treatment-induced bone loss: a consensus position statement from a UK Expert Group.

Cancer Treat Rev 2008;34  :S1–S18.

Gibson, Kelli, O’Bryant, Cindy L
Screening and management of osteoporosis in breast cancer patients on aromatase inhibitors
Journal of Oncology Pharmacy Practice 2008 14: 139-145

Winer EP, Hudis C, Burstein HJ, et al. American Society of Clinical Oncology Technology Assessment on the Use of Aromatase Inhibitors As Adjuvant Therapy for Postmenopausal Women with Hormone Receptor-Positive Breast Cancer: Status Report 2004. Journal of Clinical Oncology2005 Jan 20;23(3):619–29.

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