Heel Ultrasound can Assess Maintenance of Bone Mass in Women with Breast Cancer
Cancer and Bone (Basic, Trans. and Clinical)
Osteoporosis - Treatment (Clinical)
Poster Sessions, Presentation Number: MO0122
Session: Poster Session III & Poster Tours
Monday, October 18, 2010 11:30 AM - 1:30 PM, Metro Toronto Convention Centre, South Building, South Building: Hall E
* Gabrielle Langmann, University of Pittsburgh, USA, Karen Vujevich, University of Pittsburgh, USA, Donna Medich, University of Pittsburgh, USA, Megan Miller, University of Pittsburgh, USA, Subashan Perera, University of Pittsburgh, USA, Susan Greenspan, University of Pittsburgh, USA
Postmenopausal women with breast cancer on aromatase inhibitors (AIs) are at increased risk for bone loss and fractures. Bisphosphonates are known to prevent bone loss in women on or off AIs. While bone mineral density (BMD) can be assessed by conventional dual energy absorptiometry (DXA), little information is available on changes in bone mass assessed by portable heel ultrasound, which can be performed at a routine oncology office visit as opposed to DXA. To examine if heel ultrasound could assess changes following bisphosphonate therapy in women with breast cancer, we performed a secondary analysis of a two-year, double-blind, placebo-controlled, randomized clinical trial in 87 newly postmenopausal women, status post chemotherapy for nonmetastatic breast cancer. This included 43 patients randomized to once weekly risedronate (RIS) and 44 patients randomized to placebo (PBO). All received calcium and vitamin D if dietary intake was insufficient. Outcomes included the percent change in heel ultrasound (QUS-2 ultrasonometer, Quidel Corp, Mountainview, CA) by broadband ultrasound attenuation (BUA, dB/MHz) and conventional BMD (g/cm2) assessed by DXA of the spine, total hip and femoral neck (Hologic Discovery, Hologic Inc, Bedford, MA).
Results: At baseline the mean age was 50 years and 49% were classified as normal, 48% had low bone mass and 2% had osteoporosis. 13% of women were on AIs at randomization and 44% at 24 months. Over 24 months, heel ultrasound bone mass remained stable in women on RIS (Table). In comparison, women on PBO had a decrease of 5.2 ± 1.3% (p<0.05). Total hip and femoral neck BMD assessed by DXA decreased in the PBO group (p<0.05) and remained stable with RIS. BMD at the spine remained stable in both groups. Heel ultrasound was moderately associated with BMD at the total hip (r=0.50), femoral neck (r=0.40) and spine (r=0.46), all p<0.001.
Conclusion: In women with breast cancer on or off aromatase inhibitors, RIS helps maintain skeletal integrity as assessed by heel ultrasound. Heel ultrasound is associated with bone mineral density at other major axial sites and may be used to follow skeletal health in these women.
Disclosures: S. Greenspan, P&G/Sanofi Aventis: Consulting fees or other remuneration (payment). S. Greenspan, Amgen: Consulting fees or other remuneration (payment). S. Greenspan, P&G/Sanofi Aventis: Research Grants. S. Greenspan, Merck: Consulting fees or other remuneration (payment).
* Presenting Authors(s): Gabrielle Langmann, University of Pittsburgh, USA