Assessment and management of bone health in women with oestrogen receptor‐positive breast cancer receiving endocrine therapy: Position statement of the Endocrine Society of Australia, the Australian and New Zealand Bone & Mineral Society, the Australasian Menopause Society and the Clinical Oncology Society of Australia

摘要: To formulate clinical consensus recommendations on bone health assessment and management of women with oestrogen receptor-positive early breast cancer receiving endocrine therapy, representatives appointed by relevant Australian Medical Societies used a systematic approach for adaptation guidelines (ADAPTE) to derive an evidence-informed position statement addressing 5 key questions. Women adjuvant aromatase inhibitors the subset premenopausal woman treated tamoxifen have accelerated loss increased fracture risk. Both bisphosphonates denosumab prevent loss; additionally, has proven antifracture benefit. considering therapy need risk assessment, including factors, biochemistry mineral density (BMD) measurement, monitoring based factors. Weight-bearing exercise, vitamin D calcium sufficiency are recommended routinely. Antiresorptive treatment should be considered in prevalent or incident morphometric fractures, T-score (or Z-scores <50 years) <-2.0 at any site, if annual is ≥5%, baseline BMD other Duration antiresorptive can individualized absolute Relative their skeletal benefits, risks adverse events treatments low. Skeletal decision-making process regarding choice duration therapy. Before during assessed regularly, optimized nonpharmacological intervention where indicated treatment, individualized, multidisciplinary approach. Clinical trials needed better delineate long-term determine efficacy interventions designed minimize these risks.