Position statement: AI-induced bone loss in postmenopausal breast cancer

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  • Bone fracture risk should be assessed in all postmenopausal patients with breast cancer starting aromatase inhibitor (AI) treatment.
  • Bone-directed therapy should be given to all patients with a T-score of <−2.0 or with a T-score of <1.5 SD with one extra risk factor besides low bone mineral density (BMD), according to a joint statement of 6 medical societies.
Why this matters
  • Based on the newest evidence, fracture incidence in patients on AI treatment is higher than previously thought: 18%-20% instead of 10% over 5 y.
Key findings & recommendations
  • Bone fracture risk should be assessed for all patients starting AIs. Risk factors for fractures include low BMD, family history of hip fracture, personal history of fragility fracture after age 50 y, oral corticosteroid use 6 mo, and smoking.
  • Bone-directed therapy should ...