Effect of aromatase inhibitors on bone densitometry and microarchitecture assessed by trabecular bone score in breast cancer

Articles in Press

Document Type : Original Article

Authors

1 Nuclear Medicine Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

2 Omid Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

10.22034/irjnm.2025.130141.1699

Abstract

Introduction: During treatment of hormone-receptor positive breast cancers, Aromatase inhibitors (AIs) are commonly used. However, AIs are recognized to induce bone density loss and increase the risk of fractures. Recently, trabecular bone score (TBS) has been introduced to assess bone microarchitecture. Our study aimed to investigate changes in bone mineral density (BMD) and TBS in breast cancer patients treated with AIs.
Methods: Fifty-one patients with a mean age 59.75 ± 10.95 and a pathology-proven diagnosis of breast cancer underwent bone mineral densitometry (BMD) using the DXA method. BMD and TBS were recorded before and 6 months after starting treatment with AIs.
Results:  By comparing the bone density measurements before and six months after starting treatment with AIs, we observed a significant decrease in bone density in the lumbar region and total hip, but no significant change in TBS. Additionally, when comparing the TBS- adjusted 10-year risk probability of major osteoporosis and hip fracture (FRAX) before and six months after starting the medication, we found no statistically significant difference between the two time points.
Conclusions: This study examined bone density and T-score in the lumbar region and total hip in breast cancer patients treated with aromatase inhibitors (AIs). The results show a clear reduction in bone density after 6 months of treatment, which lead to an increased risk of fracture in these patients. Notably, TBS, FRAX and even FRAX adjusted with TBS do not exhibit significant changes over this short-term period.

Keywords

Main Subjects

References

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Iranian Journal of Nuclear Medicine

Articles in Press, Accepted Manuscript
Available Online from 27 December 2025

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