There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
Breast cancer treatments have been associated with accelerated bone loss and increased
osteoporosis risk. In a subgroup analysis of a randomised, double-blind, placebo-controlled
study, we compared the changes in spine and total hip bone mineral density (BMD) and
biochemical markers of bone turnover in women with primary breast cancer who had received
standard therapy plus either oral clodronate 1600 mg/d (n=419) or placebo (n=432)
for 2 years. After 2 years, spine BMD was 1.92% higher in patients who received clodronate
instead of placebo (P<0.0001) and total hip BMD was 1.29% higher (P=0.002 versus placebo).
Patients who received clodronate had a median 26% reduction in levels of serum N-terminal
pro-peptide of type I procollagen (PINP)--a marker of bone turnover--after 2 years
of therapy. This compares with a median 5% increase in patients who received placebo
(P<0.0001). Effects on BMD, but not biochemical markers, persisted for up to 3 years
post-treatment. Early changes in PINP were associated with changes in BMD and the
likelihood of developing bone metastases. This study shows the use of oral clodronate
during primary breast cancer treatment is associated with reduced bone turnover and
protection against bone metastases.