Evaluating bone health in women with oestrogen receptor positive breast cancer (ERBC) starting aromatase inhibitors

AimsThere is an increase in fractures in women with oestrogen receptor positive breast cancer (ERBC) particularly those taking aromatase inhibitors (AIs). How to identify women at osteoporosis risk, assess bone health and who to treat, are questions not adequately answered by previous studies.MethodsWe present an audit of osteoporosis risk factors, bone mineral density (BMD) measurement and other data relevant to bone health (falls and laboratory tests) in 85 women with ERBC starting AIs.ResultsOnly 9/85 (11%) women overall and only 2/13 with previous peripheral fragility fractures had osteoporosis. Of note, secondary hyperparathyroidism was present in 40% of women <60 years; 67% of women 60–69 years and 75% of women >70 years.ConclusionsReliance on BMD alone to guide decisions for osteoporosis prevention treatment in those taking AIs would lead to few women being treated. Osteoporosis risk in women taking AIs is likely influenced by factors other than those encompassed by BMD alone.