The effects of hormone therapy on bone strength in premenopausal women with early breast cancer

Recent studies have found that premenopausal women with high-risk, estrogen-receptor positive early breast cancer who were given a combination of ovarian suppression and aromatase inhibition treatments to deprive the body of estrogen (rather than tamoxifen which is current standard treatment) had improved outcomes.

In older, postmenopausal women, treatments that include aromatase inhibitors can cause bone loss, which leads to loss of strength and a higher likelihood of fractures.

Given that estrogen deprivation with ovarian suppression and aromatase inhibition is a relatively new treatment for younger, premenopausal women, there is limited information on how it will affect their bones.

Dr Sabashini Ramchand will conduct a double-blind randomised controlled study to quantify the effect of ovarian suppression and aromatase inhibition on bone loss, and determine whether denosumab (a common treatment given to older women for osteoporosis) is effective in preventing this bone loss.

Dr Ramchand will also aim to identify markers that will help to predict which women will be at particularly high risk of bone loss, and examine the effect of estrogen depletion on cardiovascular risk markers (body fat distribution, diabetes and cholesterol levels) and on quality of life.

This study is expected to have an immediate impact on the clinical care of younger breast cancer survivors by providing them and their medical team with a clearer understanding of the risk-benefit ratio of estrogen depletion. This project will provide the foundation for enhancing the treatment and quality of life for young survivors of breast cancer.