The need to carefully monitor bone health and treat bone loss in women receiving anti-oestrogen therapy for breast cancer has been emphasised by a recent review in the Journal of Clinical Endocrinology and Metabolism.
Recent studies had suggested that aromatase inhibitors, including letrozole, anastrozole and exemestane, were superior to tamoxifen for improving disease-free survival in women with ER-positive breast cancer.
Tamoxifen, a selective oestrogen receptor modulator, increased bone density and reduced fractures in postmenopausal women with breast cancer. In contrast, the aromatase inhibitors accelerated the loss of bone mineral density (BMD), increased markers of bone formation and resorption, and were associated with increased fracture rates.
In nine clinical studies addressing the issue, there was an inconsistent trend for increased fractures...
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