Fracture Risk in Older, Long-Term Survivors of Early-Stage Breast Cancer
Meyers Primary Care Institute; Department of Medicine, Division of Geriatric Medicine
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.
Pawloski, Pamala A.; Geiger, Ann M.; Haque, Reina; Kamineni, Aruna; Fouayzi, Hassan; Ogarek, Jessica; Petersen, Hans V.; Bosco, Jaclyn L. F.; Thwin, Soe Soe; Silliman, Rebecca A.; and Field, Terry S., "Fracture Risk in Older, Long-Term Survivors of Early-Stage Breast Cancer" (2013). Meyers Primary Care Institute Publications and Presentations. 647.