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BMC Cancer. 2018 Jan 30;18(1):104. doi: 10.1186/s12885-018-4014-5.

Vertebral fractures among breast cancer survivors in China: a cross-sectional study of prevalence and health services gaps.

Author information

1
Section of Rheumatology, Yale School of Medicine, New Haven, CT, USA.
2
Department of Ultrasound, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
3
Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
4
Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
5
Department of Endocrinology, Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Beijing, China.
6
Section of Endocrinology, Yale School of Medicine, New Haven, CT, USA.
7
Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.
8
Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. zppumc@163.com.

Abstract

BACKGROUND:

Breast cancer survivors are at high risk for fracture due to cancer treatment-induced bone loss, however, data is scarce regarding the scope of this problem from an epidemiologic and health services perspective among Chinese women with breast cancer.

METHODS:

We designed a cross-sectional study comparing prevalence of vertebral fractures among age- and BMI-matched women from two cohorts. Women in the Breast Cancer Survivors cohort were enrolled from a large cancer hospital in Beijing. Eligibility criteria included age 50-70 years, initiation of treatment for breast cancer at least 5 years prior to enrollment, and no history of metabolic bone disease or bone metastases. Data collected included sociodemographic characteristics; fracture-related risk factors, screening and preventive measures; breast cancer history; and thoracolumbar x-ray. The matched comparator group was selected from participants enrolled in the Peking Vertebral Fracture Study, an independent cohort of healthy community-dwelling postmenopausal women from Beijing.

RESULTS:

Two hundred breast cancer survivors were enrolled (mean age 57.5 ± 4.9 years), and compared with 200 matched healthy women. Twenty-two (11%) vertebral fractures were identified among breast cancer survivors compared with 7 (3.5%) vertebral fractures in the comparison group, yielding an adjusted odds ratio for vertebral fracture of 4.16 (95%CI 1.69-10.21, p < 0.01). The majority had early stage (85.3%) and estrogen and/or progesterone receptor positive (84.6%) breast cancer. Approximately half of breast cancer survivors reported taking calcium supplements, 6.1% reported taking vitamin D supplements, and only 27% reported having a bone density scan since being diagnosed with breast cancer.

CONCLUSIONS:

Despite a four-fold increased odds of prevalent vertebral fracture among Chinese breast cancer survivors in our study, rates of screening for osteoporosis and fracture risk were low reflecting a lack of standardization of care regarding cancer-treatment induced bone loss.

KEYWORDS:

Breast cancer; Cancer treatment-induced bone loss; China; Vertebral fracture

PMID:
29378534
PMCID:
PMC5789645
DOI:
10.1186/s12885-018-4014-5
[Indexed for MEDLINE]
Free PMC Article

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