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The Research Question

A systematic review of studies from Jan. 1997 to May 2015 found that younger women (≤65) receiving tamoxifen for breast cancer treatment had no significant increase in bone fracture risk, while those on aromatase inhibitors had a higher risk compared to controls. This suggests the need for Bone Mineral Density (BMD) testing during AI treatment and appropriate osteoporosis management programs.

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The Research Question

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  1. The Research Question In younger women ( 65) treated for breast cancer, do tamoxifen and aromatase inhibitor (AI) treatments lead to clinically or statistically significant changes in bone fracture risk? RESEARCH METHOD

  2. What the Researchers Did • A systematic review of English-language RCTs and cohort studies of fracture risk • Time period: Jan. 1997 to May 2015 • Independent reviewers: two • Studies included: 16 RCTs and 6 cohort studies • Effect size: pooled risk ratios • Statistical analysis: random effects & inverse variance method

  3. What the Researchers Found Pooled risk ratio (95% confidence intervals) • Tamoxifen vs. Control: 0.95 (0.84 to 1.07) • AIs vs. Control: 1.17 (1.07 to 1.28) • AI vs. Tam: 1.35 (1.21 to 1.51) • Treatment period: 1.33 (1.21 to 1.47) • Post-treatment period: 0.99 (0.72 to 1.37)

  4. What This Means for Clinical Practice • Younger women (65) who receive tamoxifen breast cancer treatment should be encouraged to have BMD testing as recommended for women who are at the same age and have not been diagnosed with breast cancer • Younger women (65) who receive AI breast cancer treatment should be encouraged to have BMD testing as recommended by guidelines. • Optimal osteoporosis management programs, especially during the treatment period, are needed for women who receive AI breast cancer treatment

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