Effect of tamoxifen with or without gonadotropin-releasing hormone analog on DXA values in women with breast cancer

Abstract The purpose of this study was to compare the changes in DXA values including trabecular bone score (TBS) and bone mineral density (BMD) of lumbar spine (LS) and femur according to the hormone therapies including tamoxifen (TMXF) treatment with or without gonadotropin releasing hormone analo...

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Autores principales:	Eun Heui Kim, Yun Kyung Jeon, Kyoungjune Pak, Taewoo Kang, Kyung-Eun Kim, Seong-Jang Kim, In-Joo Kim, Keunyoung Kim
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2f438a0fdd9a4a17891e7ff7ff2ac674
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spelling	oai:doaj.org-article:2f438a0fdd9a4a17891e7ff7ff2ac6742021-12-02T13:30:17ZEffect of tamoxifen with or without gonadotropin-releasing hormone analog on DXA values in women with breast cancer10.1038/s41598-021-82824-x2045-2322https://doaj.org/article/2f438a0fdd9a4a17891e7ff7ff2ac6742021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-82824-xhttps://doaj.org/toc/2045-2322Abstract The purpose of this study was to compare the changes in DXA values including trabecular bone score (TBS) and bone mineral density (BMD) of lumbar spine (LS) and femur according to the hormone therapies including tamoxifen (TMXF) treatment with or without gonadotropin releasing hormone analog (GnRH analog) in women with breast cancer. We enrolled 119 women with breast cancer who had undergone breast-conserving surgery or mastectomy followed by TMXF treatment for postmenopausal women (TMXF group, n = 63, 52.9%) or by combination therapy of TMXF combined with GnRH analog for premenopausal women (TMXF + GnRH group, n = 56, 47.1%) from December 2013 to December 2017. The median follow-up period was 13 months (interquartile range [IQR], 12.0–14.75) for TMXF group and 13.5 months (IQR, 12.00–16.00) for TMXF + GnRH group, respectively. Patients did not receive bone-modifying therapy. The baseline dual-energy X-ray absorptiometry (DXA) scan before breast cancer surgery and follow-up DXA during hormone therapy. Comparing the first and follow-up DXA results, BMD in LS were significantly decreased in both TMXF (P < 0.001, mean difference: − 0.06) and TMXF + GnRH (P < 0.001, mean difference: − 0.09) groups. BMD values of femoral neck (P = 0.0011, mean difference: − 0.01) and total femur (P < 0.001, mean difference: − 0.03) was significantly changed between the baseline and follow-up DXA in TMXF + RnRH group. In the TMX group, a significant changed occurred in the BMD in total femur (P < 0.001, mean difference: − 0.030) but not the BMD of femoral neck (P = 0.095, mean difference: − 0.007). Regarding TBS, no significant change was found in the TMXF (P = 0.574, mean difference: − 0.004) group, whereas there was a significant decrease in TBS in the TMXF + GnRH (P < 0.001, mean difference: − 0.02) group during follow-up. TBS is more sensitive in reflecting the bone microarchitecture changes by TMXF or GnRH agonist in breast cancer patients than BMD. This finding demonstrates that TBS can be a useful parameter to detect bone microarchitectural changes in clinical applications.Eun Heui KimYun Kyung JeonKyoungjune PakTaewoo KangKyung-Eun KimSeong-Jang KimIn-Joo KimKeunyoung KimNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Eun Heui Kim Yun Kyung Jeon Kyoungjune Pak Taewoo Kang Kyung-Eun Kim Seong-Jang Kim In-Joo Kim Keunyoung Kim Effect of tamoxifen with or without gonadotropin-releasing hormone analog on DXA values in women with breast cancer
description	Abstract The purpose of this study was to compare the changes in DXA values including trabecular bone score (TBS) and bone mineral density (BMD) of lumbar spine (LS) and femur according to the hormone therapies including tamoxifen (TMXF) treatment with or without gonadotropin releasing hormone analog (GnRH analog) in women with breast cancer. We enrolled 119 women with breast cancer who had undergone breast-conserving surgery or mastectomy followed by TMXF treatment for postmenopausal women (TMXF group, n = 63, 52.9%) or by combination therapy of TMXF combined with GnRH analog for premenopausal women (TMXF + GnRH group, n = 56, 47.1%) from December 2013 to December 2017. The median follow-up period was 13 months (interquartile range [IQR], 12.0–14.75) for TMXF group and 13.5 months (IQR, 12.00–16.00) for TMXF + GnRH group, respectively. Patients did not receive bone-modifying therapy. The baseline dual-energy X-ray absorptiometry (DXA) scan before breast cancer surgery and follow-up DXA during hormone therapy. Comparing the first and follow-up DXA results, BMD in LS were significantly decreased in both TMXF (P < 0.001, mean difference: − 0.06) and TMXF + GnRH (P < 0.001, mean difference: − 0.09) groups. BMD values of femoral neck (P = 0.0011, mean difference: − 0.01) and total femur (P < 0.001, mean difference: − 0.03) was significantly changed between the baseline and follow-up DXA in TMXF + RnRH group. In the TMX group, a significant changed occurred in the BMD in total femur (P < 0.001, mean difference: − 0.030) but not the BMD of femoral neck (P = 0.095, mean difference: − 0.007). Regarding TBS, no significant change was found in the TMXF (P = 0.574, mean difference: − 0.004) group, whereas there was a significant decrease in TBS in the TMXF + GnRH (P < 0.001, mean difference: − 0.02) group during follow-up. TBS is more sensitive in reflecting the bone microarchitecture changes by TMXF or GnRH agonist in breast cancer patients than BMD. This finding demonstrates that TBS can be a useful parameter to detect bone microarchitectural changes in clinical applications.
format	article
author	Eun Heui Kim Yun Kyung Jeon Kyoungjune Pak Taewoo Kang Kyung-Eun Kim Seong-Jang Kim In-Joo Kim Keunyoung Kim
author_facet	Eun Heui Kim Yun Kyung Jeon Kyoungjune Pak Taewoo Kang Kyung-Eun Kim Seong-Jang Kim In-Joo Kim Keunyoung Kim
author_sort	Eun Heui Kim
title	Effect of tamoxifen with or without gonadotropin-releasing hormone analog on DXA values in women with breast cancer
title_short	Effect of tamoxifen with or without gonadotropin-releasing hormone analog on DXA values in women with breast cancer
title_full	Effect of tamoxifen with or without gonadotropin-releasing hormone analog on DXA values in women with breast cancer
title_fullStr	Effect of tamoxifen with or without gonadotropin-releasing hormone analog on DXA values in women with breast cancer
title_full_unstemmed	Effect of tamoxifen with or without gonadotropin-releasing hormone analog on DXA values in women with breast cancer
title_sort	effect of tamoxifen with or without gonadotropin-releasing hormone analog on dxa values in women with breast cancer
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/2f438a0fdd9a4a17891e7ff7ff2ac674
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Effect of tamoxifen with or without gonadotropin-releasing hormone analog on DXA values in women with breast cancer

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