ECE2023 Poster Presentations Calcium and Bone (83 abstracts)
Assessment of dxa derived bone geometry parameters in early breast cancer patients: a cross-sectional study
Walter Vena 1 , Rebecca Pedersini 2 , Deborah Cosentini 2 , Luca Rinaudo 3 , Manuel Zamparini 2 , Fabio Massimo Ulivieri 4 , Di Mauro Pierluigi 2 , Filippo Maffezzoni 5 , Sara Monteverdi 3 , Lara Laini 2 , Vito Amoroso 2 , Edda Lucia Simoncini 5 , Davide Farina 6 , Andre Gerardo Lania 7 , Alfredo Berruti 8 & Gherardo Mazziotti 7
1Cliniche Gavazzeni Humanitas, Diabetology & Endocrinology Unit, Bergamo, Italy; 2Spedali Civili Brescia, Medical Oncology; 3Tecnologie Avanzate Srl, Turin, Italy; 4Casa di Cura la Madonnina, Italy; 5ASST Spedali Civili di Brescia, Breast Unit, Italy; 6University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia, Italy; 7Humanitas University, Department of Biomedical Sciences, Rozzano (MI), Italy; 8University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Medical Oncology, Brescia, Italy
Introduction: Bone mineral density (BMD) is considered a valid surrogate of bone strength in postmenopausal women, however it lacks sensitivity in individual fracture risk assessment in the setting of women with early breast cancer (EBC) patients treated with aromatase inhibitors (AIs). Indeed, mechanical resistance of bone only partially depends on bone quantity, and bone geometry and size play an important role in bone resistance to fractures. In this cross-sectional study, we assessed for the first time the association between vertebral fractures (VFs) and parameters of bone geometry in women with EBC patients treated with AIs. Moreover, we aimed also to provide a preliminary information on the possible effects of anti-resorptive drugs on bone geometry parameters.
Methods: HR-positive EBC postmenopausal women who were candidates to AIs therapy, with normal renal function, without any bone metabolic disorders, and no previous or current treatment with anti-osteoporotic drugs or glucocorticoids. Were consecutively evaluated for bone strain index (BSI), dual-X-ray absorptiometry (DXA) based parameters of bone geometry and morphometric 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, fractured patients compared to non-fractured ones presented a lower total hip BMD (mean 0.77 vs 0.84, P=0.001) and T-score (1.38 vs 0.86, P=0.001), but higher femoral BSI (femoral neck BSI 1.93 vs 1.70, P=0.001). Concerning bone geometry parameters, AI-naive fractured patients reported a significant increase in femoral narrow neck (NN) (P=0.037) endocortical width (P=0.035), femoral NN subperiosteal width (P=0.045), intertrochanteric buckling ratio (BR) (P=0.007), femoral shaft (FS) BR (P=0.007) and endocortical width (P=0.035), as compared to non-fractured patients. Some of these associations were maintained also in AI-treated women. Specifically, AIDen-fractured patients showed higher values of BR (P=0.014), lower cortical thickness (P=0.033) and higher FS endocortical width (P=0.019) as compared to non-fractured subjects. Conversely, CSA and CSMI in both IT area and FS area were significantly decreased according to the presence of VFs in the AIDen+ population.
Conclusion: This study suggests how DXA-derived bone geometry parameters can be variably associated with VFs in EBC patients, either AI-naive or AI treated in combination with denosumab. This finding reflects the need of a tailored choice of fracture risk parameters in the 3 subgroups of EBC patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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