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Comparative Study
. 2013 Jun;61(6):888-895.
doi: 10.1111/jgs.12269. Epub 2013 May 6.

Fracture risk in older, long-term survivors of early-stage breast cancer

Pamala A Pawloski  1 , Ann M Geiger  2 , Reina Haque  3 , Aruna Kamineni  4 , Hassan Fouayzi  5 , Jessica Ogarek  5 , Hans V Petersen  6 , Jaclyn L F Bosco  7   8 , Soe Soe Thwin  8   9 , Rebecca A Silliman  8 , Terry S Field  5
Affiliations
Comparative Study

Fracture risk in older, long-term survivors of early-stage breast cancer

Pamala A Pawloski et al. J Am Geriatr Soc. 2013 Jun.

Abstract

Objectives: To examine the effect of breast cancer and its treatment on fracture risk in older breast cancer survivors.

Design: A 10-year prospective cohort study beginning 5 years after a diagnosis of breast cancer for survivors and match date for comparison women.

Setting: Six integrated healthcare systems.

Participants: Women aged 65 and older (1,286 survivors, 1,286 comparison women, mean age 77.7 in both groups, white, non-Hispanic: survivors, 81.6%; comparison women, 85.2%) who were alive and recurrence free 5 years after a diagnosis of early-stage breast cancer and matched on age, study site, and enrollment year to a comparison cohort without breast cancer.

Measurements: Cox proportional hazards models were used to estimate the association between fracture risk and survivor-comparison status, adjusting for drugs and risk factors associated with bone health. A subanalysis was used to evaluate the association between tamoxifen exposure and fracture risk.

Results: No difference was observed in fracture rates between groups (hazard ratio (HR) = 1.1, 95% confidence interval (CI) = 0.9-1.3). The protective effect of tamoxifen was not statistically significant (HR = 0.9, 95% CI = 0.6-1.2).

Conclusion: Long-term survivors of early-stage breast cancer diagnosed at age 65 and older are not at greater risk of osteoporotic fractures than age-matched women without breast cancer. There appears to be no long-term protection from fractures with tamoxifen use.

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Conflict of interest statement

Conflict of Interest:

The following conflicts of interest are reported for this study: Receipt of salary for work performed on grants and contracts funded by commercial entities including Novartis and the International Serious Adverse Event Consortium (Pawloski); GlaxoSmithKline, Astra Zenica, Novartis, Amgen, Pfizer, Merck, Sanofia Aventis and others (Petersen).

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