TY - JOUR
T1 - Breast cancer outcome in relation to bone mineral density and bisphosphonate use
T2 - a sub-study of the DATA trial
AU - van Hellemond, Irene E. G.
AU - Smorenburg, Carolien H.
AU - Peer, Petronella G. M.
AU - Swinkels, Astrid C. P.
AU - Seynaeve, Caroline M.
AU - van der Sangen, Maurice J. C.
AU - Kroep, Judith R.
AU - de Graaf, Hiltje
AU - Honkoop, Aafke H.
AU - Erdkamp, Frans L. G.
AU - van den Berkmortel, Franchette W. P. J.
AU - de Roos, Wilfred K.
AU - Linn, Sabine C.
AU - Imholz, Alexander L. T.
AU - de Boer, Maaike
AU - Tjan-Heijnen, Vivianne C. G.
AU - Dutch Breast Canc Res Grp BOOG
PY - 2020/4
Y1 - 2020/4
N2 - Purpose The phase III DATA study compared 6 and 3 years of adjuvant anastrozole following 2-3 years of tamoxifen in postmenopausal breast cancer patients. This pre-planned side-study assessed the relationship between a reduced bone mineral density (BMD) and distant recurrence-free survival (DRFS), and evaluated the effect of bisphosphonates on DRFS. Methods We selected all patients with a BMD measurement within 3 years after randomisation (landmark) without any DRFS events. Kaplan-Meier methods and Cox proportional hazards models were used for analyses. Results Of 1860 eligible patients, 1142 had a DEXA scan before the landmark. The BMD was normal in 436 (38.2%) and showed osteopenia in 565 (49.5%) and osteoporosis in 141 (12.3%) patients. After a median follow-up of 5.0 years from the landmark, neither osteopenia nor osteoporosis (compared with normal BMD) were associated with DRFS in both the 6-year [osteopenia HR 0.82 (95% CI 0.45-1.49), osteoporosis HR 1.10 (95% CI 0.26-4.67)] and the 3-year arm [osteopenia HR 0.75 (95% CI 0.40-1.42), osteoporosis HR 1.86 (95% CI 0.43-8.01)]. Moreover, bisphosphonate use did not impact DRFS. Conclusion No association was observed between a reduced BMD and DRFS. Neither did we observe an impact of bisphosphonates on DRFS.
AB - Purpose The phase III DATA study compared 6 and 3 years of adjuvant anastrozole following 2-3 years of tamoxifen in postmenopausal breast cancer patients. This pre-planned side-study assessed the relationship between a reduced bone mineral density (BMD) and distant recurrence-free survival (DRFS), and evaluated the effect of bisphosphonates on DRFS. Methods We selected all patients with a BMD measurement within 3 years after randomisation (landmark) without any DRFS events. Kaplan-Meier methods and Cox proportional hazards models were used for analyses. Results Of 1860 eligible patients, 1142 had a DEXA scan before the landmark. The BMD was normal in 436 (38.2%) and showed osteopenia in 565 (49.5%) and osteoporosis in 141 (12.3%) patients. After a median follow-up of 5.0 years from the landmark, neither osteopenia nor osteoporosis (compared with normal BMD) were associated with DRFS in both the 6-year [osteopenia HR 0.82 (95% CI 0.45-1.49), osteoporosis HR 1.10 (95% CI 0.26-4.67)] and the 3-year arm [osteopenia HR 0.75 (95% CI 0.40-1.42), osteoporosis HR 1.86 (95% CI 0.43-8.01)]. Moreover, bisphosphonate use did not impact DRFS. Conclusion No association was observed between a reduced BMD and DRFS. Neither did we observe an impact of bisphosphonates on DRFS.
KW - Breast cancer
KW - Tamoxifen
KW - Aromatase inhibitor
KW - Bone health
KW - Osteoporosis
KW - Bisphosphonates
KW - Survival
KW - Bone metastases
KW - Distant recurrence-free survival
KW - ZOLEDRONIC ACID
KW - POSTMENOPAUSAL WOMEN
KW - IN-VITRO
KW - THERAPY
KW - CELLS
KW - RISK
KW - CHEMOTHERAPY
KW - METASTASIS
KW - MECHANISMS
KW - CLODRONATE
U2 - 10.1007/s10549-020-05567-9
DO - 10.1007/s10549-020-05567-9
M3 - Article
C2 - 32124136
VL - 180
SP - 675
EP - 685
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
SN - 0167-6806
IS - 3
ER -