Bone Loss
Breast cancer survivors are at increased risk for bone loss and fragility fractures due to a combination of disease, treatment, and age-related factors. A thorough clinical evaluation including history, physical examination, and laboratory and imaging studies can help identify opportunities to mitigate fracture risk. Clinicians should employ risk stratification tools such as dual-energy x-ray absorptiometry (DXA) and FRAX to assist with clinical decision-making. Robust data exists to support the use of selective estrogen receptor modulators, bisphosphonates, and denosumab in breast cancer survivors. An understanding of fracture risk along with potential treatment-related adverse effects is essential to appropriately individualize treatment decisions for bone protection.
