Younger survivors of breast cancer appear to be at higher risk for osteopenia and osteoporosis compared with cancer-free women, according to a new study published in the journal Breast Cancer Research.1 Investigators found that incident osteopenia and osteoporosis are significantly higher in young survivors of breast cancer within a few years of diagnosis than in women with no history of cancer. In addition, they found that overall risk varies by cancer treatment.

Cody Ramin, PhD, Johns Hopkins University, Baltimore, Maryland, and colleagues prospectively examined bone loss in 211 survivors of breast cancer (mean age at breast cancer diagnosis was 47 years). These women were compared with 567 cancer-free women in the same cohort who had familial risk for breast cancer.

There were 112 incident cases of osteopenia and/or osteoporosis identified during a follow-up period of 5.8 years. The researchers found that survivors of breast cancer had a 68% higher risk of osteopenia and osteoporosis compared with cancer-free women (hazard ratio [HR] = 1.68), and the association was found to be even stronger when comparing survivors diagnosed 1 year prior to study enrollment with their cancer-free peers within the first 2 years of follow-up (HR = 2.74, 95% confidence interval [CI] = 1.37–5.47).

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The study demonstrated that among survivors of breast cancer aged 50 years or younger, there was an elevated risk for osteopenia and osteoporosis.  The same was true for those who had estrogen receptor-positive tumors, and those women who were treated with aromatase inhibitors alone or chemotherapy plus any hormone therapy. The researchers concluded that a baseline evaluation of bone density and fracture risk assessment close to breast cancer diagnosis are warranted, particularly among young survivors being treated with combined chemotherapy and hormone therapy. They reported that this approach may help lead to better outcomes by allowing for earlier use of appropriate prevention strategies.


  1. Ramin C, May BJ, Roden RBS, et al. Evaluation of osteopenia and osteoporosis in younger breast cancer survivors compared with cancer-free women: a prospective cohort study. Breast Cancer Res. 2018;20:134.