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

• Autores: Pamala A. Pawloski, Ann M. Geiger, Reina Haque, Aruna Kaminen, Hassan Fouayzi, Jessica Ogarek, Hans V. Petersen, Jaclyn L. F. Bosco, Soe Soe Thwin, Rebecca A. Silliman, Terry Field
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 61, Nº. 6, 2013, págs. 888-895
• Idioma: inglés
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• Resumen

  • 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.