Current management of treatment-induced bone loss in women with breast cancer treated in the United Kingdom
New therapeutic options in breast cancer have improved survival but consequently increase the relevance of late complications. Ovarian suppression/ablation and aromatase inhibitors (AI) in the adjuvant setting have improved outcome, but have clinically important adverse effects on bone health. Howev...
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| Veröffentlicht in: | British journal of cancer 2006-01, Vol.94 (1), p.30-35 |
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| description | New therapeutic options in breast cancer have improved survival but consequently increase the relevance of late complications. Ovarian suppression/ablation and aromatase inhibitors (AI) in the adjuvant setting have improved outcome, but have clinically important adverse effects on bone health. However, investigation and management of cancer treatment-induced bone loss (CTIBL) is poorly defined with no national guidance. In 2004, a questionnaire was sent to over 500 breast surgeons and oncologists who treat breast cancer within the United Kingdom. The questionnaire evaluated access to bone densitometry and specialist expertise as well as attitudes to investigation of CTIBL and anticipated changes in the use of AI for postmenopausal early breast cancer. A total of 354 completed questionnaires were received, 47 from clinicians not currently treating breast cancer. Of the 307 evaluable questionnaires, 164 (53%) were from breast surgeons, 112 (36%) from clinical oncologists and 31 (10%) from medical oncologists. Although most respondents recognised that CTIBL was the responsibility of the treating breast team, investigations for CTIBL are limited even though most had adequate access to bone densitometry; 98 (32%) had not requested a DXA scan in the last 6 months and 224 (73%) had requested fewer than five scans. In all, 235 (76%) were not routinely investigating patients on AI for bone loss. A total of 277 (90%) felt that their practice would benefit from national guidelines to manage these patients, and the majority (59%) had little or no confidence in interpreting DXA results and advising on treatment. This questionnaire has highlighted clear deficiencies in management of CTIBL in early breast cancer. The development of national guidelines for the management of these patients and educational initiatives for breast teams are urgently required. |
| doi_str_mv | 10.1038/sj.bjc.6602892 |
| format | Article |
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Ovarian suppression/ablation and aromatase inhibitors (AI) in the adjuvant setting have improved outcome, but have clinically important adverse effects on bone health. However, investigation and management of cancer treatment-induced bone loss (CTIBL) is poorly defined with no national guidance. In 2004, a questionnaire was sent to over 500 breast surgeons and oncologists who treat breast cancer within the United Kingdom. The questionnaire evaluated access to bone densitometry and specialist expertise as well as attitudes to investigation of CTIBL and anticipated changes in the use of AI for postmenopausal early breast cancer. A total of 354 completed questionnaires were received, 47 from clinicians not currently treating breast cancer. Of the 307 evaluable questionnaires, 164 (53%) were from breast surgeons, 112 (36%) from clinical oncologists and 31 (10%) from medical oncologists. Although most respondents recognised that CTIBL was the responsibility of the treating breast team, investigations for CTIBL are limited even though most had adequate access to bone densitometry; 98 (32%) had not requested a DXA scan in the last 6 months and 224 (73%) had requested fewer than five scans. In all, 235 (76%) were not routinely investigating patients on AI for bone loss. A total of 277 (90%) felt that their practice would benefit from national guidelines to manage these patients, and the majority (59%) had little or no confidence in interpreting DXA results and advising on treatment. This questionnaire has highlighted clear deficiencies in management of CTIBL in early breast cancer. The development of national guidelines for the management of these patients and educational initiatives for breast teams are urgently required.</description><identifier>ISSN: 0007-0920</identifier><identifier>EISSN: 1532-1827</identifier><identifier>DOI: 10.1038/sj.bjc.6602892</identifier><identifier>PMID: 16317429</identifier><identifier>CODEN: BJCAAI</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>Aged ; Aromatase Inhibitors - adverse effects ; Aromatase Inhibitors - therapeutic use ; Attitude of Health Personnel ; Biological and medical sciences ; Biomedical and Life Sciences ; Biomedicine ; Bone density ; Bone Resorption - chemically induced ; Bone Resorption - drug therapy ; Breast cancer ; Breast Neoplasms - drug therapy ; Cancer Research ; Cancer therapies ; Chemotherapy, Adjuvant ; Clinical Study ; Drug Resistance ; Epidemiology ; Estrogen Receptor Modulators - adverse effects ; Estrogen Receptor Modulators - therapeutic use ; Female ; Fractures ; Gynecology. 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Obstetrics ; Health Care Surveys ; Humans ; Mammary gland diseases ; Medical research ; Medical sciences ; Middle Aged ; Molecular Medicine ; Oncology ; Ovaries ; Patient Education as Topic ; Postmenopause ; Practice Guidelines as Topic ; Practice Patterns, Physicians' - statistics & numerical data ; Questionnaires ; Tumors ; United Kingdom ; Womens health</subject><ispartof>British journal of cancer, 2006-01, Vol.94 (1), p.30-35</ispartof><rights>The Author(s) 2006</rights><rights>2006 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Jan 16, 2006</rights><rights>Copyright © 2006 Cancer Research UK 2006 Cancer Research UK</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c485t-c05d152d156d25ec014c00f74b9398332dce997dac463c073288759ddfeb95ae3</citedby><cites>FETCH-LOGICAL-c485t-c05d152d156d25ec014c00f74b9398332dce997dac463c073288759ddfeb95ae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361086/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361086/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17666156$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16317429$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lester, J E</creatorcontrib><creatorcontrib>Dodwell, D</creatorcontrib><creatorcontrib>Horsman, J M</creatorcontrib><creatorcontrib>Mori, S</creatorcontrib><creatorcontrib>Coleman, R E</creatorcontrib><title>Current management of treatment-induced bone loss in women with breast cancer treated in the United Kingdom</title><title>British journal of cancer</title><addtitle>Br J Cancer</addtitle><addtitle>Br J Cancer</addtitle><description>New therapeutic options in breast cancer have improved survival but consequently increase the relevance of late complications. Ovarian suppression/ablation and aromatase inhibitors (AI) in the adjuvant setting have improved outcome, but have clinically important adverse effects on bone health. However, investigation and management of cancer treatment-induced bone loss (CTIBL) is poorly defined with no national guidance. In 2004, a questionnaire was sent to over 500 breast surgeons and oncologists who treat breast cancer within the United Kingdom. The questionnaire evaluated access to bone densitometry and specialist expertise as well as attitudes to investigation of CTIBL and anticipated changes in the use of AI for postmenopausal early breast cancer. A total of 354 completed questionnaires were received, 47 from clinicians not currently treating breast cancer. Of the 307 evaluable questionnaires, 164 (53%) were from breast surgeons, 112 (36%) from clinical oncologists and 31 (10%) from medical oncologists. Although most respondents recognised that CTIBL was the responsibility of the treating breast team, investigations for CTIBL are limited even though most had adequate access to bone densitometry; 98 (32%) had not requested a DXA scan in the last 6 months and 224 (73%) had requested fewer than five scans. In all, 235 (76%) were not routinely investigating patients on AI for bone loss. A total of 277 (90%) felt that their practice would benefit from national guidelines to manage these patients, and the majority (59%) had little or no confidence in interpreting DXA results and advising on treatment. This questionnaire has highlighted clear deficiencies in management of CTIBL in early breast cancer. The development of national guidelines for the management of these patients and educational initiatives for breast teams are urgently required.</description><subject>Aged</subject><subject>Aromatase Inhibitors - adverse effects</subject><subject>Aromatase Inhibitors - therapeutic use</subject><subject>Attitude of Health Personnel</subject><subject>Biological and medical sciences</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Bone density</subject><subject>Bone Resorption - chemically induced</subject><subject>Bone Resorption - drug therapy</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Cancer Research</subject><subject>Cancer therapies</subject><subject>Chemotherapy, Adjuvant</subject><subject>Clinical Study</subject><subject>Drug Resistance</subject><subject>Epidemiology</subject><subject>Estrogen Receptor Modulators - adverse effects</subject><subject>Estrogen Receptor Modulators - therapeutic use</subject><subject>Female</subject><subject>Fractures</subject><subject>Gynecology. 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Obstetrics</topic><topic>Health Care Surveys</topic><topic>Humans</topic><topic>Mammary gland diseases</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Molecular Medicine</topic><topic>Oncology</topic><topic>Ovaries</topic><topic>Patient Education as Topic</topic><topic>Postmenopause</topic><topic>Practice Guidelines as Topic</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Questionnaires</topic><topic>Tumors</topic><topic>United Kingdom</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lester, J E</creatorcontrib><creatorcontrib>Dodwell, D</creatorcontrib><creatorcontrib>Horsman, J M</creatorcontrib><creatorcontrib>Mori, S</creatorcontrib><creatorcontrib>Coleman, R E</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lester, J E</au><au>Dodwell, D</au><au>Horsman, J M</au><au>Mori, S</au><au>Coleman, R E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Current management of treatment-induced bone loss in women with breast cancer treated in the United Kingdom</atitle><jtitle>British journal of cancer</jtitle><stitle>Br J Cancer</stitle><addtitle>Br J Cancer</addtitle><date>2006-01-16</date><risdate>2006</risdate><volume>94</volume><issue>1</issue><spage>30</spage><epage>35</epage><pages>30-35</pages><issn>0007-0920</issn><eissn>1532-1827</eissn><coden>BJCAAI</coden><abstract>New therapeutic options in breast cancer have improved survival but consequently increase the relevance of late complications. Ovarian suppression/ablation and aromatase inhibitors (AI) in the adjuvant setting have improved outcome, but have clinically important adverse effects on bone health. However, investigation and management of cancer treatment-induced bone loss (CTIBL) is poorly defined with no national guidance. In 2004, a questionnaire was sent to over 500 breast surgeons and oncologists who treat breast cancer within the United Kingdom. The questionnaire evaluated access to bone densitometry and specialist expertise as well as attitudes to investigation of CTIBL and anticipated changes in the use of AI for postmenopausal early breast cancer. A total of 354 completed questionnaires were received, 47 from clinicians not currently treating breast cancer. Of the 307 evaluable questionnaires, 164 (53%) were from breast surgeons, 112 (36%) from clinical oncologists and 31 (10%) from medical oncologists. Although most respondents recognised that CTIBL was the responsibility of the treating breast team, investigations for CTIBL are limited even though most had adequate access to bone densitometry; 98 (32%) had not requested a DXA scan in the last 6 months and 224 (73%) had requested fewer than five scans. In all, 235 (76%) were not routinely investigating patients on AI for bone loss. A total of 277 (90%) felt that their practice would benefit from national guidelines to manage these patients, and the majority (59%) had little or no confidence in interpreting DXA results and advising on treatment. This questionnaire has highlighted clear deficiencies in management of CTIBL in early breast cancer. The development of national guidelines for the management of these patients and educational initiatives for breast teams are urgently required.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>16317429</pmid><doi>10.1038/sj.bjc.6602892</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aromatase Inhibitors - adverse effects Aromatase Inhibitors - therapeutic use Attitude of Health Personnel Biological and medical sciences Biomedical and Life Sciences Biomedicine Bone density Bone Resorption - chemically induced Bone Resorption - drug therapy Breast cancer Breast Neoplasms - drug therapy Cancer Research Cancer therapies Chemotherapy, Adjuvant Clinical Study Drug Resistance Epidemiology Estrogen Receptor Modulators - adverse effects Estrogen Receptor Modulators - therapeutic use Female Fractures Gynecology. Andrology. Obstetrics Health Care Surveys Humans Mammary gland diseases Medical research Medical sciences Middle Aged Molecular Medicine Oncology Ovaries Patient Education as Topic Postmenopause Practice Guidelines as Topic Practice Patterns, Physicians' - statistics & numerical data Questionnaires Tumors United Kingdom Womens health |
| title | Current management of treatment-induced bone loss in women with breast cancer treated in the United Kingdom |
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