Fracture Risk Among Breast Cancer Survivors
Journal - Archives of Internal Medicine
Methods A prospective cohort (5.1 years’ follow-up)study design was used. Breast cancer survivors were women whoreported a history of breast cancer (n = 5298). Areference group included women who had no cancer history atbaseline (n = 80 848). Fracture occurrence wasascertained from annual self-reports. Hip fractures were confirmedby reviewing medical records.Results After adjustment for age, weight, ethnicity, andgeographic region of enrollment, the hazard ratios (HRs) ofbreast cancer survivors to women in the reference group were0.93 (95% confidence interval [CI], 0.64-1.33) for hip; 1.36(95% CI, 1.16-1.59) for forearm or wrist; 1.31 (95% CI, 1.19-1.43)for eligible fractures other than hip, vertebral, and forearmor wrist; and 1.31 (95% CI, 1.21-1.41) for these fractures combined.The increased risk for clinical vertebral fracture was statisticallysignificant only among survivors who had a breast cancer diagnosisbefore age 55 years (HR, 1.78; 95% CI, 1.28-2.46). After adjustingfor factors related to hormone levels, risk of fall, fracturehistory, medication use, comorbidity, and lifestyle, the increasedrisk for all fractures studied among survivors was reduced to15% (HR, 1.15; 95% CI, 1.05-1.25).Conclusions Postmenopausal survivors of breast cancerare at increased risk for clinical fractures. Preventions andtherapeutic interventions are needed to reduce fracture riskin this large and growing population.