The impact of bone mineral density screening on incident fractures and healthcare resource utilization among postmenopausal breast cancer survivors treated with aromatase inhibitors

Summary Bone mineral density screening prior to initiating aromatase inhibitor therapy was associated with lower incident bone fractures and healthcare resource utilization among postmenopausal breast cancer survivors. Introduction Postmenopausal women with hormone receptor–positive breast cancer (B...

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Bibliographic Details
Published in:Osteoporosis international 2022-09, Vol.33 (9), p.1989-1997
Main Authors: Bailey, S., Mhango, G., Lin, J. J.
Format: Article
Language:English
Subjects:
Aromatase
Bone density
Bone loss
Bone mineral density
Breast cancer
Congestive heart failure
Coronary artery disease
Dementia disorders
Dual energy X-ray absorptiometry
Endocrinology
Epidemiology
Fractures
Health care
Medicine
Medicine & Public Health
Morbidity
Original Article
Orthopedics
Osteoporosis
Post-menopause
Resource utilization
Rheumatology
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Summary:Summary Bone mineral density screening prior to initiating aromatase inhibitor therapy was associated with lower incident bone fractures and healthcare resource utilization among postmenopausal breast cancer survivors. Introduction Postmenopausal women with hormone receptor–positive breast cancer (BC) often receive aromatase inhibitor (AI) therapy. However, AIs induce bone loss and BC survivors are at an increased risk of bone fractures. This study determined whether receipt of baseline dual-energy x-ray absorptiometry (DXA) screening is associated with decreased incident fractures and lower healthcare resource utilization. Methods We retrospectively analyzed 22,713 stage 0–III primary BC survivors who received AI therapy ≤ 1 year prior to BC diagnosis from the Medicare-Linked Surveillance, Epidemiology, and End-Results database. We categorized DXA screening for those who had a procedural claim within 12 months prior through 6 months after first AI claim. We used propensity score methods to assess the association of DXA screening with bone fractures and health resource utilization. Results Of the study cohort, 62% received a DXA screening. Women with comorbid dementia, renal disease, and congestive heart failure were less likely to receive a DXA. After adjusting for confounders, BC survivors who received a DXA had a 32% decreased risk of any bone fracture compared to those who did not (hazard ratio (HR): 0.68, 95% confidence interval ( CI ): 0.60–0.76, p  
ISSN:0937-941X
1433-2965
DOI:10.1007/s00198-022-06458-z