FRACTURE RISK ASSESSMENT IN PATIENTS TREATED FOR BREAST CANCER

Ciljevi : Cilj ovog istraživanja bio je procijeniti rizik prijeloma u žena liječenih zbog karcinoma dojke u odnosu na postmenopauzalne žene bez karcinoma dojke. Materijali i metode: Istraživanje je provedeno u Regionalnom centru za dijabetes, endokrinologiju i bolesti metabolizma Kliničkog bolničkog centra Split. U istraživanju je sudjelovalo 86 postmenopauzalnih žena. Glavnu skupinu činile su 43 ispitanice koje su liječene od karcinoma dojke, a kontrolnu skupinu 43 ispitanice koje nisu bolovale od karcinoma dojke. Za prikupljanje podataka o ispitanicama korišten je anketni upitnik, nalaz denzitometrije iz kojih se računao FRAX te nalaz TBS-a. Rezultati: Ispitanice liječene zbog karcinoma dojke i postmenopauzalne žene koji nisu liječene zbog karcinoma dojke imali su niže vrijednosti BMD-a, a prema prosječnoj T- vrijednosti na vratu bedrene kosti obje skupine ispitanica imale su osteopeniju. Rezultati su pokazali da nema statistički značajnih razlika među promatranim skupinama u vrijednostima BMD lumbalne kralježnice (P= 0,07), BMD kuka (P= 0,15) i BMD vrata bedrene kosti (P= 0,29), kao i u T-vrijednosti za lumbalnu kralježnicu (P= 0,14), T-vrijednosti za kuk (P= 0,171) i T-vrijednost za vrat bedrene kosti (P=0,17). Ispitanice liječene zbog karcinoma dojke i zdrave, postmenopauzalne žene imale su narušenu mikroarhikteturu kosti, ali nije ustanovljena statistički značajna razlika među promatranim skupinama u TBS -u (P=0,55). Naposljetku, obje skupine ispitanica, prema rezultatima FRAX-a, nisu imale visok desetogodišnji rizik za velike osteoporotične prijelome i prijelome kuka i nije bilo statistički značajne razlike među promatranim skupinama u desetogodišnjem riziku za velike osteoporotične prijelome (P= 0,49) i prijelome kuka (P= 0,62). Zaključak: Naše istraživanje je pokazalo da su bolesnice liječene zbog karcinoma dojke imale podjednaku mineralnu gustoću kosti i trabekularnu strukturu kosti u odnosu na zdrave, postmenopauzalne žene. Rizik prijeloma u bolesnica liječenih zbog karcinoma dojke bio je jednak riziku prijeloma zdravih, postmenopauzalnih žena. Daljnja istraživanja s većim uzorkom su potrebna kako bi se mogli donositi zaključci.Objectives: The aim of this study was to assess fracture risk in women treated for breast cancer compared to postmenopausal women without breast cancer. Materials and methods: The research was conducted at the Regional Center for Diabetes, Endocrinology and Metabolism Diseases of the Clinical Hospital Center Split. 86 postmenopausal women participated in the study. The main group consisted of 43 subjects treated for breast cancer, and the control group consisted of 43 subjects who did not have breast cancer. To collect data on subjects we used a survey questionnaire, TBS results and densitometry findings from which FRAX was calculated. Results : Subjects treated for breast cancer and postmenopausal women not treated for breast cancer had lower BMD values, and according to the average T-score in the femoral neck, both groups of subjects had osteopenia. The results showed that there were no statistically significant differences between the observed groups in the BMD values of the lumbar spine (P=0,07), hip (P=0,15) and femoral neck (P=0,29), as well as in the T-scores for the lumbar spine (P=0,14), hip (P=0,171) and femoral neck (P=0,17). Subjects treated for breast cancer and healthy, postmenopausal women had impaired bone microarchitecture, but no statistically significant difference was found between the observed groups in TBS (P=0,55). Finally, both groups of subjects, according to FRAX results, did not have a high ten-year risk neither for major osteoporotic fractures nor hip fractures and there were no statistically significant differences between the observed groups in the ten-year risk for major osteoporotic fractures (P=0,49) and hip fractures (P=0,62). Conclusion: : Our study showed that patients treated for breast cancer had equal bone mineral density and trabecular bone structure compared to healthy, postmenopausal women. The fracture risk in patients treated for breast cancer was equal to the fracture risk in healthy, postmenopausal women. Further research with a larger sample is neccessary in order to draw more detailed conclusions