Preventing and mitigating skeletal-related events in breast cancer

Each year, more than 290,000 cases of breast cancer are diagnosed, making it the leading cause of cancer among females in the United States. Although earlier screening and more effective treatment options have improved outcomes among people with breast cancer, more than 43,000 people die from this type of cancer each year. Throughout the course of breast cancer management, bone health remains an important consideration. In early breast cancer, chemotherapy-induced ovarian failure and endocrine therapy can contribute to BMD loss and subsequent osteoporosis and fracture. In advanced breast cancer, about 70% of all patients will experience bone metastases, placing patients at risk for SREs. In fact, breast cancer is associated with the highest risk of SREs among all tumor types.

Maintaining bone health in patients with breast cancer requires routine monitoring and proactive management to minimize the risk of BMD loss, osteoporosis, and SREs. Guidelines therefore recommend that patients with non-metastatic breast cancer initiating aromatase inhibitors or other treatment that causes bone loss undergo dual-energy X-ray absorptiometry (DXA) scans to assess baseline BMD. Furthermore, patients at risk for osteoporosis should receive regular follow-up DXA scans to monitor for BMD loss. This represents an opportunity for ongoing education about the need for monitoring to ensure maintenance of optimal bone health.

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Details

Each year, more than 290,000 cases of breast cancer are diagnosed, making it the leading cause of cancer among females in the United States. Although earlier screening and more effective treatment options have improved outcomes among people with breast cancer, more than 43,000 people die from this type of cancer each year. Throughout the course of breast cancer management, bone health remains an important consideration. In early breast cancer, chemotherapy-induced ovarian failure and endocrine therapy can contribute to BMD loss and subsequent osteoporosis and fracture. In advanced breast cancer, about 70% of all patients will experience bone metastases, placing patients at risk for SREs. In fact, breast cancer is associated with the highest risk of SREs among all tumor types.

Maintaining bone health in patients with breast cancer requires routine monitoring and proactive management to minimize the risk of BMD loss, osteoporosis, and SREs. Guidelines therefore recommend that patients with non-metastatic breast cancer initiating aromatase inhibitors or other treatment that causes bone loss undergo dual-energy X-ray absorptiometry (DXA) scans to assess baseline BMD. Furthermore, patients at risk for osteoporosis should receive regular follow-up DXA scans to monitor for BMD loss. This represents an opportunity for ongoing education about the need for monitoring to ensure maintenance of optimal bone health.

Learning Objectives

By the end of the session the participant will be able to:

  • Describe the benefits of bone-modifying therapy for patients with early or advanced breast cancer.
  • Recall the relative efficacy and safety of presently available agents used for bone health and fracture prevention in patients with breast cancer.
  • Identify candidates for different bone-modifying therapies using the most recent guideline recommendations.
  • Using details in a patient case, recommend an appropriate pharmacotherapeutic treatment plan for the purpose of preventing SREs in patients with breast cancer.

Target Audience

The following healthcare professionals: medical and radiation oncologists, primary care physicians, and endocrinologists; physician assistants, nurse practitioners, and pharmacists who treat breast cancer; and any other healthcare professionals who commonly care for patients with breast cancer.

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