{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T02:43:28Z","timestamp":1784861008169,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T00:00:00Z","timestamp":1529625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asia-Pac J Clncl Oncology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Unlike anastrozole, the effect of long\u2010term exemestane (EXE) therapy on bone mineral density (BMD) is still unknown. We assessed changes in BMD from baseline to 5 years of EXE treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Postmenopausal women with endocrine\u2010responsive breast cancer receiving EXE as adjuvant therapy were enrolled in this study. EXE was administered for 5 years. The BMD of the lumbar spine (LS) and femoral neck (FN) was assessed by dual\u2010energy X\u2010ray absorptiometry at baseline and after 6 months and 1, 2, 3, 4, 5 and 6 years. Oral bisphosphonate (Bis) treatment was initiated when patients were diagnosed with osteoporosis with a T\u2010score of \u22122.5 or lower.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010one patients were enrolled in the study between 2005 and 2010. The median follow\u2010up period was 54.9 months. Forty\u2010two patients were administered Bis. Overall, the BMD of the LS increased by 7.3% from baseline and that of the FN increased by 3.4% with 5 years of EXE treatment. At the sixth year (i.e. 1 year after the treatment), BMD of the LS increased by 7.2% and that of the FN increased by 5.7%. Furthermore, the BMD of the FN increased by 12.0% in patients treated upfront with Bis and by 1.2% in those not treated with Bis (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0262). Fractures developed in nine patients (11.1%) and seven (8.6%) had fragility fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Oral Bis improves BMD of the FN in patients with osteoporosis. Five\u2010year EXE treatment with proper addition of Bis helps maintain the BMD of the LS and FN at the sixth year.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajco.13034","type":"journal-article","created":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T09:30:00Z","timestamp":1529659800000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Long\u2010term effect of exemestane therapy on bone mineral density supported by bisphosphonates: Results of 5\u2010year adjuvant treatment in postmenopausal women with early\u2010stage breast cancer"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8459-4920","authenticated-orcid":false,"given":"Akira","family":"Hirano","sequence":"first","affiliation":[{"name":"Department of Breast Surgery Tokyo Women's Medical University, Medical Center East  Tokyo 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