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This pre-planned side-study assessed the relationship between a reduced bone mineral density (BMD) and distant recurrence-free survival (DRFS), and evaluated the effect of bisphosphonates on DRFS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We selected all patients with a BMD measurement within 3\u00a0years after randomisation (landmark) without any DRFS events. Kaplan\u2013Meier methods and Cox proportional hazards models were used for analyses.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of 1860 eligible patients, 1142 had a DEXA scan before the landmark. The BMD was normal in 436 (38.2%) and showed osteopenia in 565 (49.5%) and osteoporosis in 141 (12.3%) patients. After a median follow-up of 5.0\u00a0years from the landmark, neither osteopenia nor osteoporosis (compared with normal BMD) were associated with DRFS in both the 6-year [osteopenia HR 0.82 (95% CI 0.45\u20131.49), osteoporosis HR 1.10 (95% CI 0.26\u20134.67)] and the 3-year arm [osteopenia HR 0.75 (95% CI 0.40\u20131.42), osteoporosis HR 1.86 (95% CI 0.43\u20138.01)]. Moreover, bisphosphonate use did not impact DRFS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>No association was observed between a reduced BMD and DRFS. Neither did we observe an impact of bisphosphonates on DRFS.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10549-020-05567-9","type":"journal-article","created":{"date-parts":[[2020,3,2]],"date-time":"2020-03-02T20:02:51Z","timestamp":1583179371000},"page":"675-685","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Breast cancer outcome in relation to bone mineral density and bisphosphonate use: a sub-study of the DATA trial"],"prefix":"10.1007","volume":"180","author":[{"name":"the Dutch Breast Cancer Research Group (BOOG)","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene E. 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MdB reports research grants from Roche, Eisai, Novartis, Pfizer, and Lily during the conduct of the study; and consultation\/speakers fee from Roche, Novartis, and Pfizer. VCGT-H reports consultant\/advisory role to Pfizer, Lily, and Novartis, and grants to the institute for research from AstraZeneca, Roche, Novartis, Pfizer, and Lilly during the conduct of the study. FWPJvdB, FLGE, HdG, AH, ALTI, JRK, PGMP, WKdR, MJCvdS, CMS, CHS declare no conflicts of interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}