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More Than Half of Breast Cancer Patients Have Osteopaenia or Osteoporosis Regardless of Hormone Receptor Status: Presented at SABCS

By Coriene E. Hannapel

SAN ANTONIO, TX -- December 13, 2002 --- Osteopaenia or osteoporosis, identified by dual energy x-ray absorptiometry (DEXA) results obtained within one year of diagnosis for primary breast cancer, has been found in approximately 60 percent of patients, whether their tumours are oestrogen-receptor (ER) and progesterone-receptor (PR) positive or negative.

Results of a retrospective review were presented on December 12^th at the 25^th Annual San Antonio Breast Cancer Symposium in San Antonio, Texas, by study author Catherine H. Van Poznak, MD, Assistant Clinical Physician, Memorial Sloan-Kettering Cancer Center (MSKCC), New York, United States.

Dr. Van Poznak and colleagues at MSKCC undertook this review to attempt to clarify the association between bone mineral density (BMD), hormone receptor status and breast cancer.

Previous studies have shown that obese women have increased levels of endogenous oestrogen, Dr. Van Poznak said. Increased oestrogen levels have also been correlated with both increased BMD and ER positive breast cancers, so BMD may serve as a marker for the risk of breast cancer. "We wanted to look at the situation from the other end," Dr. Van Poznak said. "We wanted to look at women who already had cancer and determine what their bone mineral density was."

Records for 53 women seen at MSKCC for DEXA between January 7, 2002 and May 15, 2002 who were diagnosed with operable primary breast cancer after January 2, 2001 were examined. Tumour stage, hormonal receptor status, and DEXA results were noted. The women ranged in age from 32 to 82 years, with a median age of 60, and included tumour stages T1-T4; N0-N1 and M0. The patients' mean weight was 68 kilograms. Of this group, 70 percent received adjuvant chemotherapy at MSKCC.

Of the 14 patients (26 percent of the total group) whose tumours were ER and PR negative, eight (57 percent of the negative hormone receptor group) had DEXA scans demonstrating osteopaenia or osteoporosis. For the 39 patients (74 percent of the total group) who had ER- and/or PR-positive tumours, 24 patients (62 percent of the hormone positive group) had DEXA scans demonstrating osteopaenia or osteoporosis. "So the percentage having osteopaenia or osteoporosis was very similar in both groups," Dr. Van Poznak said.

This was a small study, she said, but it may point to ways to look at hormone receptor status and BMD and the implications for breast cancer risk reduction. Future prospective studies should include assessment of BMD at the time of breast cancer diagnoses and should include serial BMD assessments in order to define the extent to which systemic adjuvant breast cancer therapies affect BMD, the doctor concluded.

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