SciELO - Scientific Electronic Library Online

vol.12 issue1Differences in bone mineral metabolism normocalcemic primary hyperparathyroidism with respect to classical primary hyperparathyroidism author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google


Revista de Osteoporosis y Metabolismo Mineral

On-line version ISSN 2173-2345Print version ISSN 1889-836X


GARCIA-GIRALT, N et al. Risk factors for incident fracture in patients with breast cancer treated with aromatase inhibitors: B-ABLE cohort. Rev Osteoporos Metab Miner [online]. 2020, vol.12, n.1, pp.7-13.  Epub June 15, 2020. ISSN 2173-2345.


Aromatase inhibitors (AI) have been associated with an accelerated loss of bone mass and an increased risk of osteoporosis fractures. This study assesses the risk factors for incident fracture in breast cancer patients receiving AI.

Material and methods:

Prospective-observational cohort study of women with breast cancer who begin treatment with AI (B-ABLE cohort). Patients were treated for 5 years or 2 or 3 years if they had previously received tamoxifen. Bone health was assessed from the beginning of the treatment until one year post treatment by bone densitometry, bone remodeling markers, vitamin D levels and an anteroposterior and lateral spine radiography. The fracture risk calculation was performed using the FRAX® tool before starting AI. Cox models were used to calculate the risk ratios (HR [95% CI]) of fracture.


A total of 943 patients were included in the study. 5.4% suffered an incident fracture, most during AI treatment, although 21.5% occurred during the first year after the end of therapy. Most of the incident fractures were clinical vertebral (29.4%) and Colles (31.4%). 86.3% of the patients had a diagnosis of osteopenia or osteoporosis at the time of the fracture and 33% had the levels of β-CTX (β isomer of the carboxyterminal telopeptide of type I collagen) above normal.

Patients diagnosed with osteoporosis or at risk of fracture at the start of the study were treated with bone antiresorptives. No significant differences in fracture risk were found between patients with and without antiresorptive therapy: HR=1.75 [95% CI: 0.88 to 3.46]. Nor were differences found among patients who had previously treated with tamoxifen compared to those who did not (HR=1.00 [95% CI 0.39 to 2.56]). The FRAX® tool gave average values within the intermediate risk range, with 13 patients with high risk of major fracture values.


The main risk factor detected for incident fracture in patients treated with AI is the diagnosis of osteopenia or osteoporosis. The calculation of the FRAX® tool and the determination of β-CTX levels are useful tools to identify high-risk patients.

Keywords : Aromatase inhibitors; fracture; breast cancer.

        · abstract in Spanish     · text in English | Spanish     · English ( pdf ) | Spanish ( pdf )