Effect of Chemotherapy and Hormonal Therapy on Bone Mineral Density in Patients with Breast Cancer in Saiful Anwar Hospital Malang
DOI:
https://doi.org/10.21776/ub.crjim.2020.001.01.4Keywords:
breast cancer, bone mineral density hormonal therapy, osteoporosisAbstract
Osteoporosis is an important health problem, and the number of patients who suffered from it is increasing. Breast cancer is a condition that has a high risk of osteoporosis. Cancer induced bone disease results from the primary disease, metastatic process, or from therapies against the prime condition, causing bone fragility. Therefore, there are still different opinions regarding the therapeutic effect of breast cancer on bone mineral density. Aim: to determine the effect of chemotherapy and hormonal therapy on bone mineral density in patients with breast cancer in Saiful Anwar Hospital Malang. Method: this is a case-control study conducted in 30 patients with breast cancer who had undergone chemotherapy and hormonal therapy are compared to 30 patients without breast cancer as controls. Bone Mineral Density (BMD) was measured by DEXA. Result: there are 53% of breast carcinoma patients having osteopenia and 13% having osteoporosis, with one patient has osteoporosis located in the femoral neck and three patients in lumbar (L1-L4). We obtain a significant T-score (p=0.02) in the great trochanter. Odds Ratio (OR) 0.233 with p = 0.008 showed a protective effect of chemotherapy and hormonal therapy for breast cancer to the bone density. Conclusion: the incidence of osteoporosis in the study was 13%, with the most location in the lumbar spine. Chemotherapy and hormonal therapy had a protective effect on BMD in patients with breast cancer in Saiful Anwar Hospital Malang.
References
Clifford R. Osteoporosis. Goldman's Cecil Medicine; twenty-fourth edition. 2013; 1577-1587. [https://doi.org/10.1016/C2009-0-42832-0]
World Health Organization Regional Office for Europe. What Evidence is there for the Prevention and Screening of Osteoporosis? 2009.
Guglielmi G, Muscarella S, Bazzocchi A. Integrated Imaging Approach to Osteoporosis: State-of-the-Art Review and Update. RSNA. 2011; 1343-1364. [doi: 10.1148/rg.315105712]
Julia O, Totosy de Zepetnek, Giangregorio LM, Craven C. Whole-Body Vibration as Potential Intervention for People with Low Bone Mineral Density and Osteoporosis: a Review. Journal of Rehabilitation research and development. 2009; 4(46): 529-542.[doi:10.1682/JRRD.2008.09.0136]
Tori H. Osteoporosis. Textbook of Natural Medicine, Fourth Edition. Elsevier Inc. 2013; 194:1662-1677.
Cosman F, Lindsay R, LeBoff MS, de Beur, Tanner B. Clinician’s Guide to Prevention and Treatment of Osteoporosis. National Osteoporosis Foundation. 2014. [doi: 10.1007/s00198-014-2794-2]
Depkes. Pedoman Pengendalian Osteoporosis. Jakarta. 2008.
Advances in Osteoporosis: Better Identification of Risk Factors can Reduce Morbidity and Mortality. J. Internal Med. 1996. 239(4): 299–304. [https://doi.org/10.1046/j.13652796.1996.429781000.x]
Kawiyana I Ketut S. Osteoporosis Patogenesis Diagnosis dan Penanganan Terkini. J Peny Dalam. 2009; 5(10):157-168.
World Health Organization. The Assessment of Osteoporosis at Primary Health Care Level. 2004.
Spanik S, Spanikova S. Bone Mineral Density in Early Breast Cancer Patients. Bratisl Lek Listy. 2010; 111(1):27-32.
Rizzoli R, Body J, Brandi ML, Cannata-Andia J, Chappard D, El Maghraoui, Glüer C, et al. Cancer-Associated Bone Disease. International Osteoporosis Foundation and National Osteoporosis Foundation. 2013. [doi: 10.1007/s00198-013-2530-3]
National Osteoporosis Society. Breast Cancer Treatments and Osteoporosis. 2008.[doi: 10.1159/000368843]
Reid DM, Doughty J. Guidance for the Management of Breast Cancer Treatment Induced Bone Loss: a Consensus Position Statement from a UK Expert Group. Cancer Treat Rev. Elsevier Ltd. UK. 2008;34:S1–S18. [doi: 10.1016/j.jbo.2017.03.001]
Body J. Prevention and Treatment of Side-Effects of Systemic Treatment: Bone Loss. Annals of Oncology. 2001; 21( 7): vii180–vii185.
Hadji P, Gnant M, Body J, Bundred NJ, Brufsky M, Coleman RE, Guise TA, et al. Cancer Treatment-Induced Bone Loss in Premenopausal Women: a Need for Therapeutic Intervention? Cancer Treatment Reviews. 2012; (38); 798–806.
Raisz G. Pathogenesis of Osteoporosis: Concepts, Conflicts, and Prospects. J. Clin. Invest. 2005;115:3318–3325. [doi: 10.1172/JCI27071]
Berliere M, Duhoux F, Galant C, Dalenc F, Baurain JF, Leconte I, et al. Chemotherapy-Related Amenorrhea in Breast Cancer: Review of the Main Published Studies, Biomarkers of Ovarian Function and Mechanisms Involved in Ovarian Toxicity. 2011. Available from: http://www.intechopen.com/books/amenorrhea/chemotherapy-related-amenorrhea-in-breast-cancer-review-ofthe-main-published-studies-biomarkers-of
Hadji P. Aromatase Inhibitor-Associated Bone Loss in Breast Cancer Patients is Distinct from Postmenopausal Osteoporosis. Critical Reviews in Oncology/Hematology. 2009; (69): 73–82.
Shuster LT, Rhodes DJ, Gostout BS, Grossardt BR, and Roccae WA. Premature Menopause or Early Menopause: long-term health consequences. Maturitas, 2010; 65(2): 161.
North American Menopause Society. Management of Osteoporosis in Postmenopausal Women: 2010 position statement of The North American Menopause Society. Menopause: The Journal of The North American Menopause Society. 2010; 17(1): 23-54. [doi: 10.1097/gme.0b013e3181c617e6.]
Murthy V, Chamberlain NS. Menopausal Symptoms in Young Survivors of Breast Cancer: A Growing Problem Without an Ideal Solution. Cancer Control. 2012;10(19): 317-329.
Chandra L. Akurasi Indeks Singh dibandingkan Dual Energy X-Ray Absorptiometry (DEXA) dalam Evaluasi Osteoporosis (Studi Kasus pada Pasien Karsinoma Payudara dengan Reseptor Estrogen Positif). 2013.
Inoue H, Hirano A, Ogura K, Hattori A, Kamimura M, Okubo F, et al. The Effect of Anastrozole on Bone Mineral Density during the First 5 Years of Adjuvant Treatment in Postmenopausal Women with Early Breast Cancer. Springer Plus. 2015; 4:303-7.
[DOI: 10.1186/s40064-015-1096-2]
Guise TA. Bone Loss and Fracture Risk Associated with Cancer Therapy. The Oncologist. 2006;11:1121–1131.
[DOI: 10.1158/1078-0432.ccr-10-1595]
Lee W, Cheng H, Chao H, Wang P. The Role Of Selective Estrogen Receptor Modulators On Breast Cancer: from Tamoxifen to Raloxifene. Taiwan J Obstet Gynecol, 2008; 3(47); 24-31. [https://doi.org/10.1016/S1028-4559(08)60051-0]
Goldstein SR, Siddhanti S, Ciaccia AV, Plouffer L. A Pharmacological Review of Selective Oestrogen Receptor Modulators. Human Reproduction Update. 2000; 6(3): 213-234.
