Bone Health Considerations in Breast Cancer.
Study Goal
The researchers aimed to review strategies, including calcium supplementation, to manage bone health in breast cancer patients undergoing endocrine therapy.
Results Summary
The study found that calcium supplementation, alongside vitamin D and bone-modifying agents, is part of a holistic approach to maintain bone health in breast cancer patients at risk of treatment-induced bone loss. Nonpharmacologic interventions like dietary supplementation and physical activity were also emphasized.
Population
Breast cancer patients, particularly those with hormone-receptor-positive tumors undergoing endocrine therapy.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
endocrine therapy | neutral | local control of disease and to prevent distant recurrence | patients whose tumors are hormone-receptor positive | - | can be an important component of such therapy, but it is not without adverse events | #1 |
Ovarian suppression or estrogen restriction | decrease | bone mineral density | - | - | can have a rapid and clinically significant detrimental effect | #2 |
Ovarian suppression or estrogen restriction | increase | osteoporotic fracture | - | - | leading to potential | #3 |
A combination of routine screening, use of oral or intravenous bone-modifying agents, oral supplementation of calcium and vitamin D, and physical activity, including weight-bearing exercise | neutral | bone health | patients during treatment for breast cancer | - | are required to maintain adequate | #4 |
Nonpharmacologic interventions such as dietary supplementation and physical activity | neutral | health promotion | this patient population | - | are essential to | #5 |
OBJECTIVES: The treatment of breast cancer requires the use of multiple modalities to achieve local control of disease and to prevent distant recurrence. Among patients whose tumors are hormone-receptor positive, endocrine therapy for up to 10 years in the adjuvant setting can be an important component of such therapy, but it is not without adverse events. Ovarian suppression or estrogen restriction can have a rapid and clinically significant detrimental effect on bone mineral density, leading to potential osteoporotic fracture. This article reviews the major causes of breast cancer treatment-induced bone loss and pharmacologic and nonpharmacologic management strategies to maintain bone health in this population. DATA SOURCES: PubMed and international clinical practice guidelines were used. CONCLUSION: A holistic, long-term approach is needed to identify and offer early intervention to patients at high-risk of significant bone density loss. A combination of routine screening, use of oral or intravenous bone-modifying agents, oral supplementation of calcium and vitamin D, and physical activity, including weight-bearing exercise, are required to maintain adequate bone health during treatment for breast cancer. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses are well-situated in the primary and survivorship care teams for patients with breast cancer to provide proactive education on the need to assess and actively manage bone health. Nonpharmacologic interventions such as dietary supplementation and physical activity are essential to health promotion and are within the nursing scope of practice to emphasize with this patient population.