Adjuvant Therapy In Breast Cancer And Bone Health

Abstract

Background: breast cancer is the most common tumor in women worldwide and osteoporosis is linked to it, 70-80% of patients receive adjuvant endocrine therapy to improve prognosis; but, they accelerate bone loss and increase the risk of fractures by causing inflammation that stimulates bone breakdown and slows bone growth; Assessment of initial risk of fracture, monitoring of bone health and individualization based on initial risk, implementation of non-pharmacological measures, consideration of bone mineral density T-scores, guidance on criteria for starting antiresorptive treatment, choice of agents and duration of treatment, taking into account the oncological benefits of antiresorptive treatment. Objective: to analyze and evaluate the causes of bone loss in patients with breast cancer, adequate detection to estimate the risk of osteoporosis and fractures, prevention and therapeutic strategies for these, and the role of antiresorptive agents as adjuvant therapy. Conclusions: Despite advances in the management of bone loss induced by breast cancer, the optimal time to start antiresorptive agents and the duration of treatment remain unanswered; although, the evidence supports the use of therapeutic agents to protect bone health in breast cancer. Future clinical trials, as well as increased awareness of bone health, are needed to improve prevention, evaluation, and treatment in long-term breast cancer survivors.