Retrospective investigation of the effects of aromatase inhibitors on bone mineral density in postmenoposal breast cancer patients

The aim of this study is to evaluate the effects of aromatase inhibitors (AI) used in adjuvant treatment on bone in patients with postmenopausal breast cancer. A retrospective data analysis was performed on 100 study patients using AI and 26 control patients receiving chemotheraphy (CT) who met the inclusion and exclusion criteria. Initial (before the initiation of the hormonal therapy and CT) and first year follow-up serum calcium, 25(OH) vitamin D, parathormone (PTH) and bone mineral density (BMD) levels were determined in the study group and the control group. Initial BMD measurements of the 100 study patients in the AI group yielded 44 normal and 56 osteopenic patients. First year follow-up evaluation of 44 patients with initial normal BMD revealed osteopenia in 17 patients and osteoporosis (OP) in 1 patient; while 6 of 56 patients who were initially osteopenic were found to develop OP. A statistically significant difference was found in terms of BMD assessment before and after treatment (p<0,001). In the AI group, there was a decrease in the measurements of lumbar total, femur neck and femur total T scores after treatment (p<0,001). No statistically significant difference was found in the control group in terms of BMD assessment before and after treatment (p=1,000). Comparison of BMD measurements before and after treatment yielded no significant difference between letrazol and anastrazole groups. In evaluation to compare the effects of adjuvant CT and AI treatment on bone; the decrease in femur total and lumbar total T scores in the group receiving Aİ was higher than the group receiving CT. (respectively p=0,002, p=0,013). In conclusion, our study supports the negative effects of AIs on BMD. In our study, we showed that the effects of different AIs on BMD are similar and the decrease in BMD values was lower in the CT only group.