Chen Zhao, Maricic Michael, Pettinger Mary, Ritenbaugh Cheryl, Lopez Ana Maria, Barad David H, Gass Margery, Leboff Meryl S, Bassford Tamsen L
Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA.
Cancer. 2005 Oct 1;104(7):1520-30. doi: 10.1002/cncr.21335.
Breast cancer diagnosis and treatment may put women at higher risk for osteoporosis in later life.
In a subgroup of participants in the Women's Health Initiative Observational Study, authors of the current study investigated differences in bone mineral density (BMD, measured by dual-energy x-ray absorptiometry) between breast cancer survivors (n = 209) and a noncancer reference group (n = 5759).
In comparison to the reference group, breast cancer survivors had significantly lower total body BMD value (0.989 vs. 1.013 g/cm(2), P = 0.001) and total hip BMD value (0.823 vs. 0.845 g/cm(2), P = 0.02) at baseline after adjustment for age, race/ethnicity, years since menopause, and clinical center. These lower BMD levels were largely explained by lower usage of hormone therapy (HT) among survivors: after additional statistical adjustment for HT, hip BMD values were 0.834 versus 0.844 g/cm(2) (P = 0.26), and total body values were 1.005 versus 1.013 g/cm(2) (P = 0.33) for survivors and reference women, respectively. More than 77% of survivors with osteoporosis were undiagnosed by their healthcare providers, and this was similar to the undiagnosed rate in the reference group (85.7%). Longitudinally, breast cancer survivors in this study did not demonstrate an accelerated rate of bone loss compared with the reference population.
Associated with lower HT usage, postmenopausal survivors of breast cancer were more likely to have low BMD in comparison to other women of the same age; and many of these survivors with osteoporosis were undiagnosed.
乳腺癌的诊断和治疗可能会使女性在晚年患骨质疏松症的风险更高。
在女性健康倡议观察性研究的一部分参与者中，本研究的作者调查了乳腺癌幸存者（n = 209）和非癌症参照组（n = 5759）之间骨矿物质密度（BMD，通过双能X线吸收法测量）的差异。
在校正年龄、种族/民族、绝经后年限和临床中心因素后，与参照组相比，乳腺癌幸存者在基线时全身BMD值（0.989 vs. 1.013 g/cm²，P = 0.001）和全髋BMD值（0.823 vs. 0.845 g/cm²，P = 0.02）显著更低。幸存者中激素治疗（HT）使用率较低在很大程度上解释了这些较低的BMD水平：在对HT进行额外的统计调整后，幸存者和参照组女性的髋部BMD值分别为0.834 vs. 0.844 g/cm²（P = 0.26），全身BMD值分别为1.005 vs. 1.013 g/cm²（P = 0.33）。超过77%的骨质疏松症幸存者未被其医疗服务提供者诊断出来，这与参照组的未诊断率（85.7%）相似。从纵向来看，本研究中的乳腺癌幸存者与参照人群相比，并未表现出加速的骨质流失率。
与较低的HT使用率相关，绝经后乳腺癌幸存者与同龄其他女性相比更易出现低BMD；而且许多患有骨质疏松症的幸存者未被诊断出来。
