BoOne HeEalth ManageEment in Patients with Early Breast Cancer: A Retrospective Italian Osteoncology Center “Real-Life” Experience (BOHEME Study)

• Main Authors: Federica Recine, Alberto Bongiovanni, Flavia Foca, Laura Mercatali, Valentina Fausti, Sebastiano Calpona, Nada Riva, Alessandro De Vita, Chiara Liverani, Chiara Spadazzi, Giacomo Miserocchi, Giandomenico Di Menna, Lorena Gurrieri, Claudia Cocchi, Roberto Vespignani, Toni Ibrahim, Silvia Angela Debonis
• Format: Article
• Language: English
• Published: MDPI AG 2019-11-01
• Series: Journal of Clinical Medicine
• Subjects: bone health; breast cancer; hormone therapy; bone-modifying agents; denosumab; zoledronic acid
• Online Access: https://www.mdpi.com/2077-0383/8/11/1894

Background: We assessed the real-life clinical impact of bone health management in patients with breast cancer (BC) receiving adjuvant endocrine therapy at an Italian Osteoncology Center. Methods: Pre- and post-menopausal women undergoing adjuvant endocrine therapy for early-stage BC who came to our institute for their first bone health evaluation from January 2011 to June 2016 were considered in this retrospective observational study. Results: 1125 pre- and post-menopausal early-stage BC patients (209 and 916, respectively) were evaluated. Median age was 61 years (range 26−88). In the pre-menopausal group, spinal x-ray revealed that 10 patients (4.7%) had a morphometric vertebral fracture. Higher age (OR: 1.14; 95% CI: 1.01−1.29) and bone mineral density (BMD) ≤ −2.5 (OR: 14.45; 95% CI: 1.70−122.67) were associated with a higher risk of bone fracture. The overall frequency of bone fracture was 17.6% (n = 161) in post-menopausal patients and a lower risk for bone fractures was associated with tamoxifen or other treatments (OR: 0.25; 95% CI: 0.12−0.53), presence of back pain (OR: 1.65; 95% CI: 1.16−2.36), lower BMD (OR: 2.09 in patients with T-score ≤ 2.5; 95% CI: 1.21−3.59) and lower vitamin D levels (OR: 1.57 in patients with ≤ 10 ng/mL; 95% CI: 1.05−2.34) in univariate analysis. Conclusion: Our findings confirm that bone health management should be an integral part of long-term cancer care.