Assessment of DXA derived bone quality indexes and bone geometry parameters in early breast cancer patients: A single center cross-sectional study.
Bone Rep
; 18: 101654, 2023 Jun.
Article
em En
| MEDLINE
| ID: mdl-36700242
ABSTRACT
Background:
Bone mineral density (BMD) lacks sensitivity in individual fracture risk assessment in early breast cancer (EBC) patients treated with aromatase inhibitors (AIs). New dual-energy X-ray absorptiometry (DXA) based risk factors are needed.Methods:
Trabecular bone score (TBS), bone strain index (BSI) and DXA parameters of bone geometry were evaluated in postmenopausal women diagnosed with EBC. The aim was to explore their association with morphometric vertebral fractures (VFs). Subjects were categorized in 3 groups in order to evaluate the impact of AIs and denosumab on bone geometry AI-naive, AI-treated minus (AIDen-) or plus (AIDen+) denosumab.Results:
A total of 610 EBC patients entered the study 305 were AI-naive, 187 AIDen-, and 118 AIDen+. In the AI-naive group, the presence of VFs was associated with lower total hip BMD and T-score and higher femoral BSI. As regards as bone geometry parameters, AI-naive fractured patients reported a significant increase in femoral narrow neck (NN) endocortical width, femoral NN subperiosteal width, intertrochanteric buckling ratio (BR), intertrochanteric endocortical width, femoral shaft (FS) BR and endocortical width, as compared to non-fractured patients. Intertrochanteric BR and intertrochanteric cortical thickness significantly increased in the presence of VFs in AIDen- patients, not in AIDen+ ones. An increase in cross-sectional area and cross-sectional moment of inertia, both intertrochanteric and at FS, significantly correlated with VFs only in AIDen+. No association with VFs was found for either lumbar BSI or TBS in all groups.Conclusions:
Bone geometry parameters are variably associated with VFs in EBC patients, either AI-naive or AI treated in combination with denosumab. These data suggest a tailored choice of fracture risk parameters in the 3 subgroups of EBC patients.
AI, aromatase inhibitor; AIDen+, aromatase inhibitor with denosumab; AIDen-, aromatase inhibitor without denosumab; Aromatase inhibitors; BMD, bone mineral density; BMI, body-mass index; BR, buckling ratio; BSI, bone strain index; Bone strain index; CSA, cross-sectional area; CSMI, cross-sectional moment of inertia; DXA, dual-energy X-ray absorptiometry; Dual-energy X-ray absorptiometry; EBC, early breast cancer; FS, femoral shaft; HAL, hip axis length; HR, hormone receptor; HSA, Hip Structure Analysis; IT, intertrochanteric; NN, narrow neck; NSA, neck shaft angle; PS, propensity score; ROC, receiver operator characteristic; TBS, trabecular bone score; VF, vertebral fracture; Vertebral fractures; Z, modulus
Texto completo:
1
Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article