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. 2016 Nov 22;115(11):1400-1407.
doi: 10.1038/bjc.2016.314. Epub 2016 Oct 4.

Risk of hospitalisation and death due to bone fractures after breast cancer: a registry-based cohort study

Edoardo Colzani  1   2 , Mark Clements  1 , Anna L V Johansson  1 , Annelie Liljegren  3 , Wei He  1 , Judith Brand  1 , Jan Adolfsson  4   5 , Tommy Fornander  3 , Per Hall  1 , Kamila Czene  1
Affiliations

Risk of hospitalisation and death due to bone fractures after breast cancer: a registry-based cohort study

Edoardo Colzani et al. Br J Cancer. .

Abstract

Background: Bone fractures may have an impact on prognosis of breast cancer. The long-term risks of bone fracture in breast cancer patients have not been thoroughly studied.

Methods: Poisson regression was used to investigate the incidence of hospitalisation due to bone fracture comparing women with and without breast cancer based on Swedish National registers. Cox regression was used to investigate the risk of being hospitalised with bone fracture, and subsequent risk of death, in a regional cohort of breast cancer patients.

Results: For breast cancer patients, the 5-year risk of bone fracture hospitalisation was 4.8% and the 30-day risk of death following a bone fracture hospitalisation was 2.0%. Compared with the general population, breast cancer patients had incidence rate ratios of 1.25 (95% CI: 1.23-1.28) and 1.18 (95% CI: 1.14-1.22) for hospitalisation due to any bone fracture and hip fracture, respectively. These ratios remained significantly increased for 10 years. Comorbidities (Charlson Comorbidity Index ⩾1) were associated with the risk of being hospitalised with bone fracture. Women taking aromatase inhibitors were at an increased risk as compared with women taking tamoxifen (HR=1.48; 95% CI: 0.98-2.22). Breast cancer patients hospitalised for a bone fracture showed a higher risk of death (HR=1.83; 95% CI: 1.50-2.22) compared with those without bone fracture.

Conclusions: Women with a previous breast cancer diagnosis are at an increased risk of hospitalisation due to a bone fracture, particularly if they have other comorbidities.

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Figures

Figure 1
Figure 1
Rate ratios for hospitalisation due to bone fracture after breast cancer diagnosis by time since diagnosis and by attained age, Swedish national cohort, 1990–2010.
Figure 2
Figure 2
Risk of first hospitalisation due to bone fracture after breast cancer diagnosis by age and Charlson Comorbidity Index (CCI) in women from the SBCR regional cohort, Stockholm–Gotland counties, 1990–2006.
Figure 3
Figure 3
Risk of first hospitalisation due to bone fracture by tamoxifen/aromatase inhibitors after breast cancer diagnosis in women from the SBCR regional cohort, Stockholm–Gotland counties, 2005–2008, with additional merge to the Swedish Prescribed Drug Register and follow-up until 2013. Premenopausal women, women diagnosed with distant metastases, women aged >75 years at diagnosis, and women with a bone fracture history before breast cancer diagnosis were excluded from this analysis.
See this image and copyright information in PMC

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