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April 18, 2021  
SHOULDER NEWS: Feature Story

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  • Breast Cancer Survivors at Risk for Bone Fractures

    Breast Cancer Survivors at Higher Risk for Bone Fractures

    March 31, 2005

    By: Diana Barnes-Brown for Shoulder1

    While many women worry about keeping their bones strong and stable as they age, survivors of breast cancer may need to take special care to preserve bone health and strength, say health experts.

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    Quick Facts on Breast Cancer

    1. The American Cancer Society estimates that in 2005, about 211,240 women in the U.S. will be found to have breast cancer and 40,410 women will die from the disease.

    2. Breast cancer is the second leading cause of death in women.

    3. The chance a woman will have breast cancer in her life is approximately 1 in 7.

    4. The chance a woman will die from breast cancer is about 1 in 33.

    5. There are currently more than 2 million women living in the U.S. who have been through breast cancer treatment.

    6. Breast cancer death rates are falling as diagnosis and treatment techniques. the American Cancer Society sites early detection (by way of regular breast self exams and mammograms) is a key component in preventing breast cancer deaths.

    New research from the University of Arizona, Tucson has used data from the Women’s Health Initiative Observational Study (WHI-OS) to draw conclusions about the effects of living through breast cancer on bone density.

    The research, published in an article in the March 14 issue of Archives of Internal Medicine, found that postmenopausal breast cancer survivors may have a higher risk of fractures in bones excluding the hip bone than their counterparts who have not undergone breast cancer treatments.

    The study was conducted by Zhao Chen, Ph.D., M.P.H. and colleagues at the University of Arizona. The team compared bone fracture rates in a group of 5,298 women who had breast cancer with a group of 80,848 women who had no history of breast cancer over a five-year period of time. Women gave information on their fracture histories and experiences in questionnaire form, and the fractures were placed into four categories: hip, forearm/wrist, spine or back, and other fractures.

    Chen and colleagues found that aside from hip fractures, which seemed to occur with the same frequency in both groups, “fracture rates were higher in the breast cancer survivors than in the reference group. Overall, breast cancer survivors may sustain 68.6 excess fractures per 10,000 person-years compared with other women in the same age group.” (A person-year is defined as the number of the persons multiplied by the number of years of observation.)

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    Quick Facts on Bone Health

    1. At some point in early adulthood, people reach peak bone density. Throughout life, some bone cells are made as some are depleted.

    2. At the time of peak bone density, more cells are being made than are depleted, but as people age, the balance shifts somewhat, so that more bone cells are lost than replaced.

    3. If bone loss is severe enough, this can lead to osteoporosis, or porous, easily broken bones.

    4. Bone density tests are painless tests that use small amounts of radiation to give a measurement of the amount of minerals in the bones. These tests show how much bone has been lost and give doctors an idea of how likely a patient is to develop. osteoporosis.

    The researchers adjusted the figures to account for other risk factors, including medication use, hormone replacement therapy, prior history or fractures and lifestyle, but found that the increased risk held true in spite of these adjustments, suggesting a likely correlation between breast cancer survival and bone fractures.

    Previous studies involving smaller populations has found that postmenopausal breast cancer survivors suffer from accelerated bone loss after chemotherapy for breast cancer and have low bone density, but others have offered inconsistent findings on fracture risk.

    With further research, noted the authors, “the excess number of fractures may be as high as 13,000 per year for the two million postmenopausal breast cancer survivors in the United States.” They concluded, “More research is needed to understand the fracture risk in this special population and to develop strategies to reduce the number of fractures among breast cancer survivors.”

    Last updated: 31-Mar-05


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