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- Mathis Grossmann1,2
- Sabashini K Ramchand1,2
- Frances Milat3,4
- Amanda Vincent5
- Elgene Lim6
- Mark A Kotowicz7,8
- Jill Hicks9
- Helena J Teede10
- 1 University of Melbourne, Melbourne, VIC
- 2 Austin Health, Melbourne, VIC
- 3 Monash University, Melbourne, VIC
- 4 Monash Medical Centre, Melbourne, VIC
- 5 Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC
- 6 Garvan Institute of Medical Research, Sydney, NSW
- 7 Deakin University, Geelong, VIC
- 8 Barwon Health, Geelong, VIC
- 9 Consumer Representative, Breast Cancer Network Australia, Melbourne, VIC
- 10 Monash Partners Academic Health Sciences Centre, Monash University, Melbourne, VIC
We thank the Endocrine Society of Australia Council (chair Warrick Inder); the Australian and New Zealand Bone and Mineral Society (ANZBMS) Council (president Emma Duncan during the writing and reviewing of this statement); the ANZBMS Therapeutics Committee (chair Richard Prince); the ANZBMS Densitometry Committee (chair Nicholas Pocock); Australasian Menopause Society board members, executive director and past presidents Jane Elliott and Anna Fenton; and the Clinical Oncology Society of Australia Council (chair Phyllis Butow) for their support, expert reviews and valuable contributions to this statement.
Mathis Grossmann has received speaker honoraria and conference support from Besins and Amgen Australia, has been an advisory board member for Otsuka, and has received research support from Bayer, Novartis, Weight Watchers and Eli Lilly. Sabashini Ramchand has received speaker honoraria from Counterpart (breast cancer). Frances Milat has received speaker honoraria and conference support from Novo Nordisk. Amanda Vincent has received speaker honoraria, conference support and research support from Amgen Australia, and has been a Cancer Australia working party member on management of menopause in women with breast cancer (honorary position). Elgene Lim has received speaker honoraria and conference support from Roche, Novartis and Amgen Australia, has been an advisory board member for TEVA, Novartis, Roche, Pfizer Oncology and Bayer, and has received research support from Bayer and Novartis. Mark Kotowicz has received speaker honoraria and conference support from Amgen Australia and Eli Lilly, has been an advisory board member for Amgen Australia and Eli Lilly, and has received research support from Amgen Australia. Helena Teede has received speaker honoraria and conference support from Novo Nordisk, has been an advisory board member for Diabetes Australia Victoria (honorary position), has received research support from Janssen Cilag, and is director of the Epworth Sleep Centre, Melbourne.
Abstract
Introduction: Representatives appointed by relevant Australian medical societies used a systematic approach for adaptation of guidelines (ADAPTE) to formulate clinical consensus recommendations on assessment and management of bone health in women with oestrogen receptor‐positive early breast cancer receiving endocrine therapy. The current evidence suggests that women receiving adjuvant aromatase inhibitors and pre‐menopausal woman treated with tamoxifen have accelerated bone loss and that women receiving adjuvant aromatase inhibitors have increased fracture risk. Both bisphosphonates and denosumab prevent bone loss; additionally, denosumab has proven anti‐fracture benefit in post‐menopausal women receiving aromatase inhibitors for hormone receptor‐positive breast cancer.
Main recommendations:
Changes in management as result of the position statement: