231P investigation of bone mineral density, muscle strength and body composition in postmenopausal women with ER+ early breast cancer

Abstract

Background: aromatase inhibitors (AIs) lead to accelerated bone loss, increasing the risk of osteoporosis. Women with obesity are at higher risk of breast cancer, but there is a lack of evidence on associations between body composition, muscle strength and bone mineral density (BMD) in these patients. This study aims to determine BMD at diagnosis in patients with AI-treated ER+ early breast cancer and to investigate associations between baseline BMD, body composition and hand grip strength (HGS).

Methods: postmenopausal women with ER+ early breast cancer were identified from the BeGIN cohort (REC:14/EE/1297). Clinical data and DEXA measurements of BMD were collected from patient electronic records. Baseline bioimpedance (BIA) derived body composition measurements were collected from the study database and HGS was extracted from case report forms. Descriptive statistical analysis techniques were performed using SPSS (version 29.0.2.0).

Results: out of 103 patients who met the study criteria only 59 (57%) had DEXA scans. 29 (49.2%) had osteopenia and 11 (18.6%) had osteoporosis. A positive correlation was found between mean total hip category and fat free mass index (FFMI) (n=59, U=122.5, p=<0.001) and lumbar spine BMD and fat mass index (FMI) (n=57, r=0.481, CI 95%=0.009-0.028, p=<0.001). No significant correlation was found between HGS and FFMI (r=0.073, CI 95%=-0.890-0.422, p=0.480) or between HGS and DEXA clinical diagnosis (n=57, r=0.006, p=0.965).

Conclusions: the majority of postmenopausal breast cancer patients have osteopenia or osteoporosis when starting AI; however, many patients do not appear to be aware of this at time of the study. No significant associations were found between muscle grip strength and measures of body composition, however there was a positive association between muscle mass by BIA and bone density by DEXA. These results will be used to inform future interventional studies for rehabilitation or exercise programmes for women with early breast cancer, specifically aiming to optimise bone health, particularly in patients with risk factors for osteoporosis.

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Identifiers

ORCID for C. Savva: orcid.org/0000-0003-0805-4719

ORCID for W. Cheah: orcid.org/0000-0003-1170-6810

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