Fracture Risk in Older, Long-Term Survivors of Early-Stage Breast Cancer

UMMS Affiliation

Meyers Primary Care Institute; Department of Medicine, Division of Geriatric Medicine



Document Type


Medical Subject Headings

Breast Neoplasms; Fractures, Bone; Osteoporotic Fractures; Postmenopause


Clinical Epidemiology | Geriatrics | Health Services Research | Neoplasms | Oncology | Women's Health


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. Geriatrics Society.


Citation: Pawloski PA, Geiger AM, Haque R, Kamineni A, Fouayzi H, Ogarek J, Petersen HV, Bosco JL, Thwin SS, Silliman RA, Field TS. Fracture risk in older, long-term survivors of early-stage breast cancer. J Am Geriatr Soc. 2013 Jun;61(6):888-95. doi: 10.1111/jgs.12269. Link to article on publisher's site

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