The Breast
Volume 19, Issue 2 , Pages 92-96, April 2010

Zoledronic acid for treatment of osteopenia and osteoporosis in women with primary breast cancer undergoing adjuvant aromatase inhibitor therapy☆☆☆

  • Stephanie L. Hines

      Affiliations

    • Mayo Clinic Florida, Jacksonville, FL 32224, USA
    • Corresponding Author InformationCorresponding author at: Mayo Clinic Florida, Breast Center, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Tel.: +1 904 953 0707; fax: +1 904 953 1412.
    • ,
  • Jeff A. Sloan

      Affiliations

    • Mayo Clinic Rochester, Rochester, MN 55905, USA
    • ,
  • Pamela J. Atherton

      Affiliations

    • Mayo Clinic Rochester, Rochester, MN 55905, USA
    • ,
  • Edith A. Perez

      Affiliations

    • Mayo Clinic Florida, Jacksonville, FL 32224, USA
    • ,
  • Shaker R. Dakhil

      Affiliations

    • Wichita Community Clinical Oncology, Wichita, KS 67214-3882, USA
    • ,
  • David B. Johnson

      Affiliations

    • Wichita Community Clinical Oncology, Wichita, KS 67214-3882, USA
    • ,
  • Pavan S. Reddy

      Affiliations

    • Wichita Community Clinical Oncology, Wichita, KS 67214-3882, USA
    • ,
  • Robert J. Dalton

      Affiliations

    • Immanuel-St. Joseph Hospital Mayo Health System, Mankato, MN 56002, USA
    • ,
  • Bassam I. Mattar

      Affiliations

    • Wichita Community Clinical Oncology, Wichita, KS 67214-3882, USA
    • ,
  • Charles L. Loprinzi

      Affiliations

    • Mayo Clinic Rochester, Rochester, MN 55905, USA

Received 19 June 2009; received in revised form 30 November 2009; accepted 1 December 2009. published online 15 January 2010.

Abstract 

Background

Postmenopausal women with osteoporosis/osteopenia are at increased risk of fracture. Aromatase inhibitors further increase bone loss in these patients. This study evaluates whether zoledronic acid prevents the bone loss expected when these patients initiate letrozole.

Patients and methods

Postmenopausal women with estrogen and/or progesterone receptor-positive breast cancer and a bone mineral density (BMD) T-score <−2.0 were given letrozole 2.5mg/vitamin D 400 international units daily, calcium 500mg twice daily, and 4mg zoledronic acid every 6months. The BMD was assessed at baseline and 1year. The primary endpoint was the mean change in lumbar spine (LS) BMD at 1year.

Results

Forty-six patients completed 1year of treatment. LS BMD increased by 2.66% (p=0.01), femoral neck (FN) by 4.81% (p=0.01), and any measured endpoint by 4.55% (p=0.0052).

Conclusions

Zoledronic acid prevents bone loss in postmenopausal women with osteoporosis/osteopenia starting letrozole and is associated with improvements in BMD.

Keywords: Breast cancer, Osteoporosis, Aromatase inhibitors

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☆ This study was conducted as a trial of the Mayo Cancer Center Research Consortium in part by Public Health Service grants CA-35431, CA-35195, and CA-52352. The content is solely the responsibility of the authors and does not necessarily represent the views of the National Cancer Institute or the National Institute of Health.

☆☆ Additional participating institutions include: Carle Cancer Center CCOP, Urbana, IL 61801 (Kendrith M. Rowland, Jr.); Cedar Rapids Oncology Project CCOP, Cedar Rapids, IA 52403 (Martin Wiesenfeld).

PII: S0960-9776(09)00173-8

doi:10.1016/j.breast.2009.12.001

The Breast
Volume 19, Issue 2 , Pages 92-96, April 2010

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