Assessment of DXA Derived Bone Quality Indexes and Bone Geometry Parameters in Early Breast Cancer Patients: A Single Center Cross-sectional Study

Overview

Journal Bone Rep

Date 2023 Jan 26

PMID 36700242

Authors

Rebecca Pedersini

Deborah Cosentini

Luca Rinaudo

Manuel Zamparini

Fabio Massimo Ulivieri

Pierluigi di Mauro

Filippo Maffezzoni

Sara Monteverdi

Walter Vena

Lara Laini

Vito Amoroso

Edda Lucia Simoncini

Davide Farina

Gherardo Mazziotti

Alfredo Berruti

Affiliations

Soon will be listed here.

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.

Citing Articles

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Denosumab improves trabecular bone score in relationship with decrease in fracture risk of women exposed to aromatase inhibitors.

Antonini S, Pedersini R, Birtolo M, Baruch N, Carrone F, Jaafar S J Endocrinol Invest. 2023; 47(2):433-442.

PMID: 37592052 DOI: 10.1007/s40618-023-02174-5.

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