{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:06:44Z","timestamp":1777468004733,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BD"],"published-print":{"date-parts":[[2023,2,14]]},"abstract":"<jats:p>Estrogen-receptor positive tumours represent the majority of breast cancers in postmenopausal women. Adjuvant endocrine therapy with aromatase inhibitors (AIs), continued for up to 10 years in high-risk patients, reduces by 40% the risk of recurrence. However, this therapy, among other side effects, is burdened with a higher incidence of osteoporotic bone fractures. To date, both bisphosphonates and denosumab are recognized as first-line drugs in the primary prevention of osteoporotic fractures in patients treated with AIs. They have demonstrated their effectiveness in increasing bone mineral density and in reducing the incidence of fractures, but they have also been shown to improve disease free survival (DFS).<\/jats:p>","DOI":"10.3233\/bd-220014","type":"journal-article","created":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T11:47:24Z","timestamp":1676634444000},"page":"1-4","source":"Crossref","is-referenced-by-count":1,"title":["Bone modifying agents in postmenopausal breast cancer patients treated with aromatase inhibitors: beyond bone protection?"],"prefix":"10.1177","volume":"42","author":[{"given":"Andrea","family":"Villasco","sequence":"first","affiliation":[{"name":", , University of Turin, , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carola","family":"Minella","sequence":"additional","affiliation":[{"name":", , University of Turin, , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina Elisabetta","family":"Bounous","sequence":"additional","affiliation":[{"name":", , University of Turin, , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Rosso","sequence":"additional","affiliation":[{"name":", , University of Turin, , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicoletta","family":"Biglia","sequence":"additional","affiliation":[{"name":", , University of Turin, , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"key":"10.3233\/BD-220014_ref1","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/S0140-6736(11)60993-8","article-title":"Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: Patient-level meta-analysis of randomised trials","volume":"378","author":"Davies","year":"2011","journal-title":"Lancet"},{"key":"10.3233\/BD-220014_ref2","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/S0140-6736(15)61074-1","article-title":"Aromatase inhibitors versus tamoxifen in early breast cancer: Patient-level meta-analysis of the randomised trials","volume":"386","author":"Bradley","year":"2015","journal-title":"Lancet"},{"issue":"5","key":"10.3233\/BD-220014_ref3","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1200\/JCO.18.01160","article-title":"Adjuvant endocrine therapy for women with hormone receptor-positive breast cancer: ASCO clinical practice guideline focused update","volume":"37","author":"Burstein","year":"2019","journal-title":"J Clin Oncol"},{"issue":"7","key":"10.3233\/BD-220014_ref4","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s12032-017-0986-2","article-title":"Extended adjuvant endocrine therapy in early breast cancer: A meta-analysis of published randomized trials","volume":"34","author":"Ibrahim","year":"2017","journal-title":"Med Oncol"},{"issue":"1","key":"10.3233\/BD-220014_ref5","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1093\/jnci\/djx141","article-title":"Toxicity of extended adjuvant therapy with aromatase inhibitors in early breast cancer: A systematic review and meta-analysis","volume":"110","author":"Goldvaser","year":"2018","journal-title":"J Natl Cancer Inst"},{"key":"10.3233\/BD-220014_ref6","unstructured":"Edwards BJ, Elevated incidence of fractures in women with invasive breast cancer, Osteoporos Int, 2016."},{"issue":"3","key":"10.3233\/BD-220014_ref7","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1158\/1078-0432.CCR-10-1595","article-title":"Cancer therapy associated bone loss: Implications for hip fractures in mid-life women with breast cancer","volume":"17","author":"Edwards","year":"2011","journal-title":"Clin Cancer Res"},{"key":"10.3233\/BD-220014_ref8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jbo.2017.03.001","article-title":"Management of aromatase inhibitor-associated bone loss (AIBL) in postmenopausal women with hormone sensitive breast cancer: Joint position statement of the IOF, CABS, ECTS, IEG, ESCEO IMS, and SIOG","volume":"7","author":"Hadji","year":"2017","journal-title":"J Bone Oncol"},{"key":"10.3233\/BD-220014_ref9","first-page":"45","article-title":"Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-month analysis of the ATAC trial","author":"Forbes","year":"2008","journal-title":"The Lancet Oncol,"},{"issue":"4","key":"10.3233\/BD-220014_ref10","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1177\/1759720X18759291","article-title":"Aromatase inhibitors are associated with a higher fracture risk than tamoxifen: A systematic review and meta-analysis","volume":"10","author":"Tseng","year":"2018","journal-title":"Ther Adv Musculoskelet Dis"},{"issue":"46","key":"10.3233\/BD-220014_ref11","doi-asserted-by":"publisher","first-page":"e403","DOI":"10.3346\/jkms.2020.35.e403","article-title":"Osteoporotic fractures of the spine, hip, and other locations after adjuvant endocrine therapy with aromatase inhibitors in breast cancer patients: A meta-analysis","volume":"35","author":"Lee","year":"2020","journal-title":"J Korean Med Sci"},{"issue":"3","key":"10.3233\/BD-220014_ref12","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1093\/annonc\/mdv617","article-title":"Adjuvant bisphosphonates in early breast cancer: Consensus guidance for clinical practice from a European panel","volume":"27","author":"Hadji","year":"2016","journal-title":"Ann Oncol"},{"key":"10.3233\/BD-220014_ref13","doi-asserted-by":"publisher","first-page":"335","DOI":"10.3389\/fonc.2020.00335","article-title":"The endosteal niche in breast cancer bone metastasis","volume":"10","author":"Haider","year":"2020","journal-title":"Front Oncol"},{"issue":"2","key":"10.3233\/BD-220014_ref14","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.medcli.2009.10.013","article-title":"Papel de los bisfosfonatos en el tratamiento adyuvante del c\u00e1ncer de mama [The role of bisphosphonates of adjuvant therapy in breast cancer]","volume":"135","author":"G\u00e1lvez-Mu\u00f1oz","year":"2010","journal-title":"Med Clin (Barc)"},{"issue":"9","key":"10.3233\/BD-220014_ref15","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.4065\/83.9.1032","article-title":"Bisphosphonates: Mechanism of action and role in clinical practice","volume":"83","author":"Drake","year":"2008","journal-title":"Mayo Clin Proc"},{"issue":"10","key":"10.3233\/BD-220014_ref16","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1002\/jbmr.2855","article-title":"Denosumab reduces cortical porosity of the proximal femoral shaft in postmenopausal women with osteoporosis","volume":"31","author":"Zebaze","year":"2016","journal-title":"J Bone Miner Res"},{"key":"10.3233\/BD-220014_ref17","doi-asserted-by":"crossref","unstructured":"Early Breast Cancer Trialists\u2019 Collaborative Group (EBCTCG). Adjuvant bisphosphonate treatment in early breast cancer: Meta-analyses of individual patient data from randomised trials, Lancet,\u00a0386(10001): 1353\u20131361, 2015.","DOI":"10.1016\/S0140-6736(15)60908-4"},{"key":"10.3233\/BD-220014_ref18","first-page":"CD003474","article-title":"Bisphosphonates and other bone agents for breast cancer","volume":"10","author":"O\u2019Carrigan","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"10.3233\/BD-220014_ref19","doi-asserted-by":"crossref","first-page":"4875","DOI":"10.1200\/JCO.2008.16.3832","article-title":"Randomized trial of denosumab in patients receiving adjuvant aromatase inhibitors for nonmetastatic breast cancer","author":"Ellis","year":"2008","journal-title":"J Clin Oncol,"},{"issue":"9992","key":"10.3233\/BD-220014_ref20","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/S0140-6736(15)60995-3","article-title":"Austrian Breast and Colorectal Cancer Study Group. Adjuvant denosumab in breast cancer (ABCSG-18): A multicentre, randomised, double-blind, placebo-controlled trial","volume":"386","author":"Gnant","year":"2015","journal-title":"Lancet"},{"issue":"1","key":"10.3233\/BD-220014_ref21","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/S1470-2045(19)30687-4","article-title":"Adjuvant denosumab in early breast cancer (D-CARE): An international, multicentre, randomised, controlled, phase 3 trial","volume":"21","author":"Coleman","year":"2020","journal-title":"Lancet Oncol"},{"issue":"3","key":"10.3233\/BD-220014_ref22","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/S1470-2045(18)30862-3","article-title":"Austrian breast and colorectal cancer study group. Adjuvant denosumab in postmenopausal patients with hormone receptor-positive breast cancer (ABCSG-18): Disease-free survival results from a randomised, double-blind, placebo-controlled, phase 3 trial","volume":"20","author":"Gnant","year":"2019","journal-title":"Lancet Oncol"},{"key":"10.3233\/BD-220014_ref23","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2200162"},{"issue":"5","key":"10.3233\/BD-220014_ref24","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1007\/s11864-021-00835-2","article-title":"Cancer treatment-induced bone loss (CTIBL): State of the art and proper management in breast cancer patients on endocrine therapy","volume":"22","author":"Diana","year":"2021","journal-title":"Curr Treat Options Oncol"},{"key":"10.3233\/BD-220014_ref25","doi-asserted-by":"crossref","unstructured":"SIOMMMS Guidelines. Rossini M et\u00a0al., Guidelines for the diagnosis, prevention and management of osteoporosis, Reumatismo, 68(1): 1\u201339, 2016.","DOI":"10.4081\/reumatismo.2016.870"},{"key":"10.3233\/BD-220014_ref26","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1007\/s00198-017-3919-1","article-title":"Observations following discontinuation of long-term denosumab therapy","volume":"28","author":"McClung","year":"2017","journal-title":"Osteoporosis International"},{"issue":"7","key":"10.3233\/BD-220014_ref27","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1002\/jbmr.3962","article-title":"A single infusion of zoledronate in postmenopausal women following denosumab discontinuation results in partial conservation of bone mass gains","volume":"35","author":"Everts-Graber","year":"2020","journal-title":"J Bone Miner Res"},{"key":"10.3233\/BD-220014_ref28","doi-asserted-by":"crossref","first-page":"152","DOI":"10.3390\/jcm10010152","article-title":"Denosumab discontinuation and the rebound phenomenon: A narrative review","volume":"10","author":"Anastasilakis","year":"2021","journal-title":"J Clin Med"},{"issue":"10","key":"10.3233\/BD-220014_ref29","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1093\/annonc\/mdz235","article-title":"Estimating the benefits of therapy for early-stage breast cancer: The St. Gallen International Consensus Guidelines for the primary therapy of early breast cancer 2019","volume":"30","author":"Burstein","year":"2019","journal-title":"Ann Oncol"}],"container-title":["Breast Disease"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/BD-220014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:32:31Z","timestamp":1777383151000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/BD-220014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,14]]},"references-count":29,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3233\/bd-220014","relation":{},"ISSN":["0888-6008","1558-1551"],"issn-type":[{"value":"0888-6008","type":"print"},{"value":"1558-1551","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,14]]}}}