{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:51:46Z","timestamp":1753883506274,"version":"3.41.2"},"reference-count":39,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"11","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>Worsening bone mineral density (BMD)\u2014and the corresponding increase in osteoporotic fractures\u2014is an important and well-established source of morbidity and mortality in women receiving treatment of breast cancer, as well as those living with HIV. However, there are comparatively few reports on pretreatment bone health in women newly diagnosed with breast cancer, especially in predominantly Black populations, across sub-Saharan Africa (SSA), and among individuals living with HIV. Therefore, we sought to characterize bone health in a cohort of Black South African women with and without HIV before the initiation of systemic breast cancer therapy, in particular chemotherapy and\/or aromatase inhibitors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>Building on the South African Breast Cancer and HIV Outcomes study, we recruited consecutive women newly diagnosed with stage I-III breast cancer who were to start systemic cancer therapy at the Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg, between June 2021 and August 2024. In addition to collecting extensive demographic and clinical information, we conducted dual energy X-ray absorptiometry (DXA) scans on each patient to measure BMD of the lumbar spine, femoral neck, and total hip.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>We enrolled a total of 378 women, 32.3% of whom (n = 122) were living with HIV. Among women aged 50 years and older (n = 156), 64.1% had osteopenia or osteoporosis; HIV infection and vitamin D insufficiency\/deficiency\u2014but no breast cancer characteristics\u2014were associated with a higher risk of osteoporosis. By contrast, 3.6% of women younger than 50 years had BMD below the expected range for age.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>Especially in low-resource clinical settings, such as public hospitals in SSA, understanding which women are at highest risk of osteoporosis and fragility fracture before the initiation of breast cancer systemic therapy is critical. Our study provides a foundation for identifying relevant risk factors and ultimately designing interventional studies that target high-risk women for intensified osteoporosis screening and management.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/go-25-00122","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T19:59:10Z","timestamp":1750276750000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Bone Mineral Density in Black South African Women Newly Diagnosed With Breast Cancer Living With and Without HIV"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8461-8374","authenticated-orcid":true,"given":"Lindor","family":"Qunaj","sequence":"first","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine and Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8616-9672","authenticated-orcid":true,"given":"Maureen","family":"Joffe","sequence":"additional","affiliation":[{"name":"Strengthening Oncology Services Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5949-4522","authenticated-orcid":true,"given":"Alfred I.","family":"Neugut","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine and Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY"},{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4994-0779","authenticated-orcid":true,"given":"Lisa K.","family":"Micklesfield","sequence":"additional","affiliation":[{"name":"SAMRC\/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13058-018-1061-4"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.11005\/jbm.2020.27.1.27"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(18)30047-0"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2008.03.007"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(07)70385-6"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32801022eb"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ010"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4464"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4765"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1086\/656412"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000260"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji250"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-022-06525-5"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-015-3154-6"},{"key":"e_1_3_5_16_2","doi-asserted-by":"crossref","first-page":"2280","DOI":"10.1001\/jama.2022.10019","article-title":"Cancer deaths may double by 2030 in sub-Saharan Africa","volume":"327","author":"Larkin HD","year":"2022","unstructured":"Larkin HD: Cancer deaths may double by 2030 in sub-Saharan Africa. 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