Hormonal deprivation therapy-induced osteoporosis in postmenopausal women with breast cancer

Aromatase inhibitor (AI) therapy significantly increases the disease-free survival in postmenopausal patients with hormone receptor-positive breast cancer. AIs are potent inhibitors of oestradiol production. Large adjuvant trials showed that the third-generation AIs (i.e., anastrozole, letrozole and exemestane) are risk factors for an increased bone loss, and are associated with an increase in the risk of fractures in women with bone fragility. A comprehensive assessment of risk of fractures must be performed at the initiation of an AI therapy. Antiresorptive drugs (i.e., bisphosphonates and denosumab) are effective for bone loss prevention and treatment in these patients.