• P J Robinson, R J Bell, C S Zecena Morales, P Fradkin, and S R Davis.
• Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Level 6 The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia, penny.robinson@monash.edu.
• Osteoporos Int. 2015 Feb 1; 26 (2): 795-800.

SummaryMinimal-trauma fracture is an important issue in breast cancer survivors, especially rib fracture. The likelihood of fracture is affected by menopausal status and a diagnosis of osteoporosis prior to breast cancer. Most women reported at least one assessment of bone mineral density.IntroductionWe have investigated the self-reported frequency and pattern of minimal-trauma fracture (MTF) in breast cancer (BC) survivors at least 5 years from diagnosis, along with the use of bone mineral density (BMD) assessment.MethodsThis study was carried out within the Bupa Health Foundation Health and Wellbeing After Breast Cancer Study which is a questionnaire-based prospective cohort study of 1683 women diagnosed with their first invasive breast cancer between 2004 and 2006 and followed for at least 5 years.ResultsOne thousand two hundred and five women, who remained free of recurrence or new breast cancer, completed the fifth annual follow-up. One hundred sixty-four (13.6%) reported at least one MTF. Rib fracture was the most common (52 fractures in 46 women). Compared with women who remained pre-/peri-menopausal, either being postmenopausal at diagnosis (OR 3.53, 95% Confidence Interval (CI) 1.09-11.44, p=0.036) or changing from pre- to postmenopausal during follow-up (OR 3.97, 95% CI 1.21-13.10, p=0.023) was associated with a higher likelihood of fracture, as was having a diagnosis of osteoporosis at the time of diagnosis (OR 1.74, 95% CI 1.00-2.99, p=0.047). Most women (64.9%) reported at least one BMD assessment.ConclusionsOverall MTF is a problem for breast cancer survivors, with rib fracture a particular issue for women in our study. Both pre-existing osteoporosis and being postmenopausal are risk factors for subsequent MTF in women treated for breast cancer. Clinicians need to be mindful of fracture prevention medication in these groups.

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