Osteoporosis and pain severity in reproductive age patients with breast cancer

Abstract

Aim. To analyze the relationship of osteoporosis in reproductive age patients with breast cancer with the pain severity and osteoporosis diagnosis improvement in these patients to improve their quality of life.

Methods. The study included 63 women aged 30 to 50 years. The studied group consisted of 33 women with confirmed diagnosis of breast cancer, control group - 30 healthy, same age women of comparison group. The examination included a blood test for osteocalcin, calcitonin, alkaline phosphatase, parathyroid hormone, thyroid stimulating hormone, calcium and phosphorus. The pain severity was evaluated by McGill pain questionnaire and pain syndrome classification. Osteodensitometry was performed to all patients of studied and control groups. All patients with «breast cancer» diagnosis were examined prior to specific treatment administration and 6 months after treatment course completion. 12 patients were examined also after neoadjuvant chemotherapy.

Results.Osteopenia (initial changes of bone tissue) was revealed in 3 (10%) cases in the control group. There was no cases of osteoporosis in the control group. Clinical manifestations in the form of the 1st level pain syndrome in healthy women was registered in 6 (20%) cases. Osteoporosis develops more often in patients who underwent complex treatment with ovarian function blocking, i.e. the artificial menopause advent. Osteoporosis in breast cancer patients after combined treatment was detected in 69.7% of cases, and pain - in 75.8% of cases. Bone mineral density indicators during treatment and after it were significantly different compared to those before treatment (p

Conclusion. In breast cancer in reproductive age patients after the complex treatment, osteoporosis and pain often develop, therefore such patients need to undergo osteodensitometry for timely osteoporosis diagnosis and treatment correction.

Keywords

breast cancer / pain / osteoporosis / chemotherapy

References

[1] Дума С.Н., Игнатова А.В., Беспалова Т.С., Авксентюк А.В. Болевой синдром при остеопорозе. Боль и её лечение. 1999; (10): 23-25.

[2] Кузьменко В.В., Фокин В.А., Маттис Э.Р. и др. Психологические методы количественной оценки боли. Соврем. мед. 1986; (10): 44-48.

[3] Лекарственная терапия рака молочной железы. Под ред. Н.И. Переводчиковой, М.Б. Стениной. М.: Практика. 2014; 181-207.

[4] Оганов В.С., Новиков В.Е., Кабицкая О.Е. и др. Остеопороз - медико-социальная проблема: патогенетические факторы и совершенствование диагностики. Технол. живых систем. 2008; 5 (5-6): 22-30.

[5] Семиглазов В.Ф., Семиглазов В.В., Палтуев Р.М. и др. Биологическое обоснование планирования лечения рака молочной железы. Врач. 2012; (11): 2-4.

[6] Снеговой А.В. Проблема остеопороза на фоне антиэстрогенной и антиандрогенной терапии. Практич. онкол. 2011; 12 (3): 136-145.

[7] Шварц Г.Я. Фармакотерапия постменопаузального остеопороза. Клин. фармакол. и терап. 1996; (1): 70-75.

[8] Coleman R.E., Abrahanson P.-A., Hadji P. Handbook of cancer-related bone disease. BioScientifica. 2010; 1-231.

[9] Gnant M., Mlineritsch B., Luschin-Ebengreuth G. et al. Adjuvant endocrine therapy plus zoledronic acid in premenopausal women with early-stage breast cancer: 5-year follow-up of the ABCSG-12 bone-mineral density substudy. Lancet. Oncol. 2008; 9: 840-849. http://dx.doi.org/10.1016/S1470-2045(08)70204-3

[10] Нadji P., Body J.J., Aapro M.S. et. al. Practical guidance for the management of aromatase inhibitor-associated bone loss. Ann. Oncol. 2008; 19: 1407-1416. http://dx.doi.org/10.1093/annonc/mdn164

[11] Kanis J.A. Pathogenesis of osteoporosis and fracture. In: Osteoporosis. London, England: Blackwell Healthcare Communications Ltd. 1997; 22-55.

[12] Sumihisa Orita, Seiji Ohtori, Gen Inoue, Kazuhisa Takahashi. Osteoporotic pain, osteoporosis. 2012. http://www.intechopen.com/books/osteoporosis/osteoporotic-pain/ (access date: 02.09.2015). http://dx.doi.org/10.5772/29691

[13] Tilman D.R., Khosla S., Hofbauer L.C. Osteoporosis: Now and the future. Lancet. 2011; 377: 1276-1287. http://dx.doi.org/10.1016/S0140-6736(10)62349-5

[14] Veronesi U., Orecchia R., Maisonneuve P. et al. Intraoperative radiotherapy versus external radiotherapy for early breast cancer (ELIOT): a randomised controlled equivalence trial. Lancet Oncol. 2013; 14: 1269- 1277. http://dx.doi.org/10.1016/S1470-2045(13)70497-2

RIGHTS & PERMISSIONS

Tretyakova N.Y., Chizhikov A.V.