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Oral bisphosphonate use and breast cancer incidence in postmenopausal women

Chlebowski, RT and Chen, Z and Cauley, JA and Anderson, G and Rodabough, RJ and McTiernan, A and Lane, DS and Manson, JAE and Snetselaar, L and Yasmeen, S and O'Sullivan, MJ and Safford, M and Hendrix, SL and Wallace, RB (2010) Oral bisphosphonate use and breast cancer incidence in postmenopausal women. Journal of Clinical Oncology, 28 (22). 3582 - 3590. ISSN 0732-183X

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Purpose: Emerging clinical evidence suggests intravenous bisphosphonates may inhibit breast cancer while oral bisphosphonates have received limited evaluation regarding breast cancer influence. Patients and Methods: The association between oral bisphosphonate use and invasive breast cancer was examined in postmenopausal women enrolled onto the Women's Health Initiative (WHI). We compared a published hip fracture prediction model, which did not incorporate bone mineral density (BMD), with total hip BMD in 10,418 WHI participants who had both determinations. To adjust for potential BMD difference based on bisphosphonate use, the hip fracture prediction score was included in multivariant analyses as a BMD surrogate. Results: Of the 154,768 participants, 2,816 were oral bisphosphonate users at entry (90% alendronate, 10% etidronate). As calculated hip fracture risk score was significantly associated with both BMD (regression line = 0.79 to 0.0478 log predicted fracture; P < .001; r = 0.43) and breast cancer incidence (P = .03), this variable was incorporated into regression analyses to adjust for BMD difference between users and nonusers of bisphopshonate. After 7.8 mean years of follow-up (standard deviation, 1.7), invasive breast cancer incidence was lower in bisphosphonate users (hazard ratio [HR], 0.68; 95% CI, 0.52 to 0.88; P < .01) as was incidence of estrogen receptor (ER) -positive invasive cancers (HR, 0.70; 95% CI, 0.52 to 0.94, P = .02). A similar but not significant trend was seen for ER-negative invasive cancers. The incidence of ductal carcinoma in situ was higher in bisphosphonate users (HR, 1.58; 95% CI, 1.08 to 2.31; P = .02). Conclusion: Oral bisphosphonate use was associated with significantly lower invasive breast cancer incidence, suggesting bisphosphonates may have inhibiting effects on breast cancer. © 2010 by American Society of Clinical Oncology.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Chlebowski, RT
Chen, Z
Cauley, JAJCauley@edc.pitt.eduJCAULEY
Anderson, G
Rodabough, RJ
McTiernan, A
Lane, DS
Manson, JAE
Snetselaar, L
Yasmeen, S
O'Sullivan, MJ
Safford, M
Hendrix, SL
Wallace, RB
Date: 1 August 2010
Date Type: Publication
Journal or Publication Title: Journal of Clinical Oncology
Volume: 28
Number: 22
Page Range: 3582 - 3590
DOI or Unique Handle: 10.1200/jco.2010.28.2095
Schools and Programs: Graduate School of Public Health > Epidemiology
Refereed: Yes
ISSN: 0732-183X
Date Deposited: 12 May 2015 19:59
Last Modified: 02 Feb 2019 15:55


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