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Aug 9, 2019 10:14AM
BRCA Mutation, Preventive Surgery, and Osteoporosis — Researchers advocate for increased hormone therapy for high-risk women
Bone health suffered in women with a BRCA mutation who underwent preventive oophorectomy, Canadian researchers reported.
Premenopausal women with the BRCA1 or BRCA2 mutation experienced a significant decline in bone mineral density (BMD) after undergoing prophylactic bilateral salpingo-oophorectomy...
"These pre-menopausal women looked a lot like post-menopausal women after a year following surgery,"
...use of hormonal therapy was able to offset most of the deleterious bone changes in both pre- and post-menopausal women after surgery.
"There are no standardized guidelines for the management of bone health in this population after surgery,"
"Given the important role of estrogen in maintaining various physiological functions, including bone health, this rate of hormone therapy use is far too low," the researchers stated, suggesting that the "mitigating effects" of hormone therapy use in this population should be noted in future clinical practice guidelines.
...suggested recommending enough calcium intake for this population, as well as engaging in weight-bearing exercise and exogenous hormone use for those for whom it is not contraindicated.
future studies with a longer follow-up period are needed to truly estimate the impact of prophylactic bilateral salpingo-oophorectomy on fracture risk in this high-risk population of women.
JAMA Network Open
Source Reference: Kotsopoulos J, et al "Changes in Bone Mineral Density After Prophylactic Bilateral Salpingo-Oophorectomy in Carriers of a BRCA Mutation" JAMA Netw Open 2019; DOI: 10.1001/jamanetworkopen.2019.8420.
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2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
1/14/2016 Herceptin (trastuzumab)
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+