{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T02:49:02Z","timestamp":1785466142395,"version":"3.56.0"},"reference-count":44,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Women with early breast cancer (EBC) exposed to aromatase inhibitors (AIs) may experience fragility fractures despite treatment with bone-active drugs. Risk factors for fractures in patients receiving AIs and denosumab have not been explored to date.<\/jats:p><\/jats:sec>Objectives<\/jats:title>To evaluate whether an association exists between dual x-ray absorptiometry (DXA)\u2013measured fat body mass (FBM) and vertebral fracture (VF) progression in postmenopausal women with EBC undergoing adjuvant therapy with AIs in combination with denosumab and to examine whether VF was associated with common risk factors for bone fracture and parameters of body composition other than FBM.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>For this prospective, single-center, cohort study, 237 patients with EBC who were undergoing adjuvant treatment with AIs and denosumab (60 mg every 6 months) were enrolled at the Breast Unit of the ASST Spedali Civili of Brescia from September 2014 to June 2018. Data analysis was conducted in June 2022.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Body composition parameters, bone mineral density, and morphometric VFs were assessed by DXA at study entry and after 18 months of therapy.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>VF progression, defined as either new or worsening of preexisting VFs, between the 2 time points.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 237 patients enrolled (median [range] age, 61 [28-84] years), 17 (4.4%) reported VF progression. Univariable analysis found an association between VF progression and a history of clinical fractures (odds ratio [OR], 3.22; 95% CI, 1.19-8.74; P<\/jats:italic>\u2009=\u2009.02), Fracture Risk Assessment Tool (FRAX) score for major fractures (OR, 4.42; 95% CI, 1.23-13.79; P<\/jats:italic>\u2009=\u2009.04), percentage of FBM (OR, 6.04; 95% CI, 1.69-21.63; P<\/jats:italic>\u2009=\u2009.006), and android fat (OR, 9.58; 95% CI, 1.17-78.21; P<\/jats:italic>\u2009=\u2009.04) and an inverse association with appendicular lean mass index\u2013FBM ratio (OR, 0.25, 95% CI, 0.08-0.82; P<\/jats:italic>\u2009=\u2009.02). Multivariable analysis revealed percentage of FBM (OR, 5.41; 95% CI, 1.49-19.59; P<\/jats:italic>\u2009=\u2009.01) and FRAX score (OR, 3.95; 95% CI, 1.09-14.39; P<\/jats:italic>\u2009=\u2009.04) as independent variables associated with VF progression.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>The findings of this study suggest that baseline FBM is an independent factor for VF progression in patients with EBC treated with adjuvant AIs and denosumab. This observation is new and indicates that diet and exercise may synergize with denosumab in the management of bone health in this patient setting.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.50950","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T16:01:09Z","timestamp":1704902469000},"page":"e2350950","source":"Crossref","is-referenced-by-count":10,"title":["Fat Body Mass and Vertebral Fracture Progression in Women With Breast Cancer"],"prefix":"10.1001","volume":"7","author":[{"given":"Deborah","family":"Cosentini","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Medical Oncology, University of Brescia, ASST Spedali Civili, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Pedersini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edda Lucia","family":"Simoncini","sequence":"additional","affiliation":[{"name":"SSVD Breast Unit, ASST Spedali Civili of Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Farina","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Radiology, University of Brescia, ASST Spedali Civili, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gherardo","family":"Mazziotti","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Milan, Italy"},{"name":"Endocrinology, Diabetology and Medical Andrology Unit, Metabolic Bone Diseases and Osteoporosis Section, IRCCS Humanitas Research Hospital, Rozzano, Milan, 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