Suboptimal BMD Evaluation in Postmenopausal Women With Early-Stage Breast Cancer Receiving Aromatase Inhibitors
In a study reported in the Journal of Oncology Practice, Stratton et al found that most postmenopausal Medicare patients with early-stage breast cancer receiving aromatase inhibitor therapy do not receive recommended bone mineral density (BMD) measurements. Most expert panels recommend BMD measurement with a dual-energy x-ray absorptiometry (DXA) scan at baseline and every 1 to 2 years in postmenopausal patients receiving aromatase inhibitors.
Study Details
The study involved a sample of 2,409 women from the Surveillance, Epidemiology, and End Results Program (SEER)-Medicare–linked database who had stage I to III breast cancer and started aromatase inhibitor therapy from January 2008 to December 2010, with follow-up through December 2012. Selection criteria included aromatase inhibitor use for ≥ 6 months and no recent osteoporosis diagnosis or bisphosphonate use. Patients had a median age of 74 years.
Baseline and Follow-up Scans
Overall, 51% of patients received a baseline DXA scan. Characteristics significantly associated with receipt of a baseline scan included older age (odds ratio [OR] = 0.62, 95% confidence interval [CI] = 0.42–0.92 for 85–94 years vs 67–69 years) and black vs white race (OR = 0.68, 95% CI = 0.47–0.97). Among patients who received a baseline scan and continued aromatase inhibitor treatment for 3 years, a repeat scan was performed in 28.0% within 2 years and in 65.9% within 3 years.
Among 1,164 patients who continued aromatase inhibitor treatment for 3 years, 34.5% had both a baseline scan and at least one follow-up scan during the 3-year period.
The investigators concluded: “The majority of older Medicare beneficiaries with breast cancer treated with [aromatase inhibitors] do not undergo appropriate bone mineral density evaluation.”
Sarah S. Mougalian, MD, of Yale University School of Medicine, is the corresponding author of the Journal of Oncology Practice article.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
