Skip to main content

Advertisement

SpringerLink
Log in

Management of cancer treatment-induced bone loss in early breast and prostate cancer - a consensus paper of the Belgian Bone Club

  • Consensus Statement
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Cancer treatment-induced bone loss (CTIBL) is one of the most important side effects of adjuvant antineoplastic treatment in hormone-dependent neoplasms. Chemotherapy, GnRH analogs and tamoxifen can induce marked bone loss in premenopausal women with early breast cancer. Aromatase inhibitors (AIs) are replacing tamoxifen as the preferred treatment for postmenopausal women. As a class effect, steroidal (exemestane) and non-steroidal (anastrozole and letrozole) AIs increase bone turnover and cause bone loss (4%–5% over 2 years). When compared to tamoxifen, the risk of getting a clinical fracture under AI treatment is increased by 35%–50%. In patients with prostate cancer, androgen deprivation therapy (ADT) increases bone turnover, reduces bone mass (4%–5% per year) and increases the fracture rate depending on the duration of therapy. Zoledronic acid can prevent accelerated bone loss induced by goserelin in premenopausal women, by letrozole in postmenopausal women and by ADT in men. More limited data indicate that weekly alendronate or risedronate could also be effective for preventing CTIBL. Initiation of therapy early, prior to the occurrence of severe osteoporosis, rather than after, may be more effective. Bisphosphonate treatment should be considered in osteoporotic but also in osteopenic patients if other risk factor(s) for fractures are present.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Pfeilschifter J, Diel IJ (2002) Osteoporosis due to cancer treatment: pathogenesis and management. J Clin Oncol 18:1570–1593

    Google Scholar 

  2. Hoff AO, Gagel RF (2005) Osteoporosis in breast and prostate cancer survivors. Oncology 19:651–658

    PubMed  Google Scholar 

  3. Cooper C (1997) The crippling consequences of fractures and their impact on quality of life. Am J Med 103:12S–17S

    Article  PubMed  CAS  Google Scholar 

  4. Shapiro CL, Manola J, Leboff M (2001) Ovarian failure after adjuvant chemotherapy is associated with rapid bone loss in women with early-stage breast cancer. J Clin Oncol 19:3306–3311

    PubMed  CAS  Google Scholar 

  5. Bruning PF, Pit MJ, de Jong-Bakker M et al (1990) Bone mineral density after adjuvant chemotherapy for premenopausal breast cancer. Br J Cancer 61:308–310

    PubMed  CAS  Google Scholar 

  6. Buzdar AU, Hortobagyi G (1998) Update on endocrine therapy for breast cancer. Clin Cancer Res 4:527–534

    PubMed  CAS  Google Scholar 

  7. Garrett TJ, Vahdat LT, Kinne DW (1997) Systemic adjuvant therapy of breast cancer. J Surg Oncol 64:167–172

    Article  PubMed  CAS  Google Scholar 

  8. Jonat W, Kaufmann M, Sauerbrei W et al (2002) Zoladex Early Breast Cancer Research Association Study. Goserelin versus cyclophosphamide, methotrexate, and fluorouracil as adjuvant therapy in premenopausal patients with node-positive breast cancer: the Zoladex Early Breast Cancer Research Association Study. J Clin Oncol 20:4628–4635

    Article  PubMed  CAS  Google Scholar 

  9. Fogelman I, Blake GM, Blamey R et al (2003) Bone mineral density in premenopausal women treated for node-positive early breast cancer with 2 years of goserelin or 6 months of cyclophosphamide, methotrexate and 5-fluorouracil (CMF). Osteoporos Int 14:1001–1006

    Article  PubMed  CAS  Google Scholar 

  10. Love RR, Mazess RB, Barden HS et al (1992) Effects of tamoxifen on bone mineral density in postmenopausal women with breast cancer. N Engl J Med 326:852–856

    Article  PubMed  CAS  Google Scholar 

  11. Powles TJ, Hickish T, Kanis JA et al (1996) Effect of tamoxifen on bone mineral density measured by dual-energy x-ray absorptiometry in healthy premenopausal and postmenopausal women. J Clin Oncol 14:78–84

    PubMed  CAS  Google Scholar 

  12. Winer EP, Hudis C, Burstein HJ, Chlebowski RT et al (2002) American Society of Clinical Oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for women with hormone receptor-positive breast cancer: status report 2002. J Clin Oncol 20:3317–3327

    Article  PubMed  CAS  Google Scholar 

  13. Winer EP, Hudis C, Burstein HJ et al (2005) American Society of Clinical Oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for postmenopausal women with hormone receptor-positive breast cancer: status report 2004. J Clin Oncol 23:619–629

    Article  PubMed  CAS  Google Scholar 

  14. Smith IE, Dowsett M (2003) Aromatase inhibitors in breast cancer. N Engl J Med 48:2431–2442

    Article  Google Scholar 

  15. Fisher B, Costantino JP, Wickerham DL et al (1998) Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst 90:1371–1388

    Article  PubMed  CAS  Google Scholar 

  16. McCloskey EV (2006) Effects of third-generation aromatase inhibitors on bone. Eur J Cancer 42:1044–1051

    Article  PubMed  CAS  Google Scholar 

  17. Goss PE, Qi S, Cheung AM, Hu H et al (2004) Effects of the F(7)steroidal aromatase inhibitor exemestane and the nonsteroidal aromatase inhibitor letrozole on bone and lipid metabolism in ovariectomized rats. Clin Cancer Res 10:5717–5723

    Article  PubMed  CAS  Google Scholar 

  18. Subar M, Goss PE, Thomsen T et al (2004) Effects of steroidal and nonsteroidal aromatase inhibitors (AIs) on markers of bone turnover and lipid metabolism in healthy volunteers. J Clin Oncol 22(14S):8038

    Google Scholar 

  19. Heshmati HM, Khosla S, Robins SP et al (2002) Role of low levels of endogenous estrogen in regulation of bone resorption in late postmenopausal women. J Bone Miner Res 17:172–178

    Article  PubMed  CAS  Google Scholar 

  20. McCloskey E, Hannon R, Lakner G et al (2006) The letrozole (L), exemestane (E) and anastrozole (A) pharmacodynamics (LEAP) trial: a direct comparison of bone biochemical measurements between aromatase inhibitors (AIs) in healthy postmenopausal women. J Clin Oncol 24(18S):555

    Google Scholar 

  21. Eastell R, Hannon RA, Cuzick J et al (2006) On behalf of the ATAC Trialists’ Group. Effect of an aromatase inhibitor on BMD and bone turnover markers: 2-year results of the anastrozole, tamoxifen, alone or in combination (ATAC) Trial (18233230). J Bone Miner Res 21:1215–1223

    Article  PubMed  CAS  Google Scholar 

  22. Geisler J, Lonning PE, Krag LE et al (2006) Changes in bone and lipid metabolism in postmenopausal women with early breast cancer after terminating 2-year treatment with exemestane: a randomized placebo-controlled study. Eur J Cancer 42:2968–2975

    Article  PubMed  CAS  Google Scholar 

  23. Cuzick J, Forbes J, Edwards R et al (2002) First results from the International Breast Cancer Intervention Study (IBIS-1): a randomiser prevention trial. Lancet 360:817–824

    Article  PubMed  CAS  Google Scholar 

  24. Fisher B, Costantino JP, Wickerham DL et al (2005) Tamoxifen for the prevention of breast cancer: current status of the National Surgical Adjuvant Breast and Bowel Project P-1 study. J Natl Cancer Inst 97:1652–1662

    Article  PubMed  CAS  Google Scholar 

  25. Baum M, Buzdar A, Cuzick J et al (2003) The ATAC (Arimidex, Tamoxifen Alone or in Combination) Trialists’ Group. Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early-stage breast cancer: results of the ATAC (Arimidex, Tamoxifen Alone or in Combination) trial efficacy and safety update analyses. Cancer 98:1802–1810

    Article  PubMed  CAS  Google Scholar 

  26. Thurlimann B, Keshaviah A, Coates AS et al (2005) Breast International Group (BIG) 1-98 Collaborative Group. A comparison of letrozole and tamoxifen in postmenopausal women with early breast cancer. N Engl J Med 353:2747–2757

    Article  PubMed  Google Scholar 

  27. Howell A, Cuzick J, Baum M et al (2005) ATAC Trialists’ Group. Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years’ adjuvant treatment for breast cancer. Lancet 365:60–62

    Article  PubMed  CAS  Google Scholar 

  28. Goss PE, Ingle JN, Martino S et al (2003) A randomized trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer. N Engl J Med 349:1793–1802

    Article  PubMed  CAS  Google Scholar 

  29. Perez EA, Josse RG, Pritchard KI, et al (2006) Effect of letrozole versus placebo on bone mineral density in women with primary breast cancer completing 5 or more years of adjuvant tamoxifen: a companion study to NCIC CTG MA-17. J Clin Oncol 24:3629–3635

    Article  PubMed  CAS  Google Scholar 

  30. Coombes RC, Hall E, Gibson LJ et al (2004) Intergroup Exemestane Study. A randomized trial of exemestane after two to three years of tamoxifen therapy in postmenopausal women with primary breast cancer. N Engl J Med 350:1081–1092

    Article  PubMed  CAS  Google Scholar 

  31. Jakesz R, Jonat W, Gnant M et al (2005) Switching of postmenopausal women with endocrine-responsive early breast cancer to anastrozole after 2 years’ adjuvant tamoxifen: combined results of ABCSG trial 8 and ARNO 95 trial. Lancet 366:455–462

    Article  PubMed  CAS  Google Scholar 

  32. Lonning PE, Geisler J, Krag LE et al (2005) Effects of exemestane administered for 2 years versus placebo on bone mineral density, bone biomarkers, and plasma lipids in patients with surgically resected early breast cancer. J Clin Oncol 23:5126–5137

    Article  PubMed  CAS  Google Scholar 

  33. Mincey BA, Duh MS, Thopmas SK, et al (2006) Risk of cancer treatment-associated bone loss and fractures among women with breast cancer receiving aromatase inhibitors. Clinical Breast Cancer 7:127–132

    Article  PubMed  CAS  Google Scholar 

  34. Martin AR, Sornay-Rendu E, Chandler JM et al (2002) The impact of osteoporosis on quality-of-life: the OFELY cohort. Bone 31:32–36

    Article  PubMed  CAS  Google Scholar 

  35. Padalecki SS, Carreon M, Grubbs B et al (2003) Androgen deprivation enhances bone loss and prostate cancer metastases to bone: prevention by zoledronic acid. Oncology 17 (Suppl):32

    Google Scholar 

  36. Body JJ (2006) Bisphosphonates for malignancy-related bone disease: current status, future developments. Support Care Cancer 14:408–418

    Article  PubMed  Google Scholar 

  37. Morris CA, Cheng H, Cabral D et al (2004) Predictors of screening and treatment of osteoporosis: a structural review of the literature. Endocrinologist 14:70–75

    Article  Google Scholar 

  38. Writing Group for the ISCD, Position Development Conference (2004) Indications and reporting for dual-energy X-ray absorptiometry. J Clin Densitom 7:37–44

    Article  Google Scholar 

  39. Hillner BE, Ingle JN, Chlebowski RT et al (2003) American Society of Clinical Oncology. American Society of Clinical Oncology 2003 update on the role of bisphosphonates and bone health issues in women with breast cancer. J Clin Oncol 21:4042–57 Erratum in: (2004) J Clin Oncol 22:1351

    Google Scholar 

  40. Saarto T, Blomqvist C, Valimaki M, Makela P, Sarna S, Elomaa I (1997) Chemical castration induced by adjuvant cyclophosphamide, methotrexate, and fluorouracil chemotherapy causes rapid bone loss that is reduced by clodronate: a randomized study in premenopausal breast cancer patients. J Clin Oncol 15:1341–1347

    PubMed  CAS  Google Scholar 

  41. Delmas PD, Balena R, Confravreux E et al (1997) Bisphosphonate risedronate prevents bone loss in women with artificial menopause due to chemotherapy of breast cancer: a double-blind, placebo-controlled study. J Clin Oncol 15:955–962

    PubMed  CAS  Google Scholar 

  42. Gnant M, Mlineritsch B, Luschin-Ebengreuth G et al (2007) Zoledronic acid effectively prevents cancer treatment-induced bone loss in premenopausal women receiving adjuvant endocrine therapy for hormone-responsive breast cancer: a report from the Austrian Breast and Colorectal Cancer Study Group. J Clin Oncol 25:820–828

    Article  PubMed  CAS  Google Scholar 

  43. Brufsky A, Harker WG, Beck JT et al (2007) Zoledronic acid inhibits adjuvant letrozole-induced bone loss in postmenopausal women with early breast cancer. J Clin Oncol 25:829–836

    Article  PubMed  CAS  Google Scholar 

  44. Moul JW (1998) Contemporary hormonal management of advanced prostate cancer. Oncology 12:499–505

    PubMed  CAS  Google Scholar 

  45. Robson M, Dawson N (1996) How is androgen-dependent metastatic prostate cancer best treated? Hematol Oncol Clin North Am 10:727–747

    Article  PubMed  CAS  Google Scholar 

  46. Eastell R (1998) Treatment of postmenopausal osteoporosis. N Engl J Med 338:736–746

    Article  PubMed  CAS  Google Scholar 

  47. Higano CS (2004) Understanding treatments for bone loss and bone metastases in patients with prostate cancer: a practical review and guide for the clinician. Urol Clin North Am 31:331–352

    Article  PubMed  Google Scholar 

  48. Maillefert JF, Sibilia J, Michel F et al (1999) Bone mineral density in men treated with synthetic gonadotropin-releasing hormone agonists for prostatic carcinoma. J Urol 161:1219–1222

    Article  PubMed  CAS  Google Scholar 

  49. Eriksson S, Eriksson A, Stege R et al (1995) Bone mineral density in patients with prostatic cancer treated with orchidectomy and with estrogens. Calcif Tissue Int 57:97–99

    Article  PubMed  CAS  Google Scholar 

  50. Daniell HW, Dunn SR, Ferguson DW et al (2000) Progressive osteoporosis during androgen deprivation therapy for prostate cancer. J Urol 163:181–186

    Article  PubMed  CAS  Google Scholar 

  51. Daniell HW (1997) Osteoporosis after orchiectomy for prostate cancer. J Urol 157:439–444

    Article  PubMed  CAS  Google Scholar 

  52. Townsend MF, Sanders WH, Northway RO et al (1997) Bone fractures associated with luteinizing hormone-releasing hormone agonists used in the treatment of prostate carcinoma. Cancer 79:545–550

    Article  PubMed  CAS  Google Scholar 

  53. Oefelein MG, Ricchuiti V, Conrad W et al (2001) Skeletal fracture associated with androgen suppression induced osteoporosis: the clinical incidence and risk factors for patients with prostate cancer. J Urol 166:1724–1728

    Article  PubMed  CAS  Google Scholar 

  54. Smith MR, Boyce SP, Moyneur E et al (2006) Risk of clinical fracture after gonadotropin-releasing hormone agonist therapy for prostate cancer. J Urol 175:136–139

    Article  PubMed  CAS  Google Scholar 

  55. Shahinian VB, Kuo YF, Freeman JL et al (2005) Risk of fracture after androgen deprivation for prostate cancer. N Engl J Med 352:154–164

    Article  PubMed  CAS  Google Scholar 

  56. Smith MR, Finkelstein JS, McGovern FJ et al (2002) Changes in body composition during androgen deprivation therapy for prostate cancer. J Clin Endocrinol Metab 87:599–603

    Article  PubMed  CAS  Google Scholar 

  57. Van Staa TP, Leufkens HG, Abenhaim L et al (2000) Use of oral corticosteroids and risk of fractures. J Bone Miner Res 15:993–1000

    Article  PubMed  Google Scholar 

  58. Van Pottelbergh I, Goemaere S, Kaufman JM (2003) Bioavailable estradiol and an aromatase gene polyorphism are determinants of bone mineral density changes in men over 70 years of age. J Clin Endocrinol Metab 88:3075–3081

    Article  PubMed  CAS  Google Scholar 

  59. Barrett-Connor E, Mueller JE, von Muhlen DG et al (2000) Low levels of estradiol are associated with vertebral fractures in older men, but not women: the Rancho Bernardo Study. J Clin Endocrinol Metab 85:219–223

    Article  PubMed  CAS  Google Scholar 

  60. Bilezikian JP, Morishima A, Bell J et al (1998) Increased bone mass as a result of estrogen therapy in a man with aromatase deficiency. N Engl J Med 339:599–603

    Article  PubMed  CAS  Google Scholar 

  61. Verhelst J, Denis L, Van Vliet P et al (1994) Endocrine profiles during administration of the new non-steroidal anti-androgen Casodex in prostate cancer. Clin Endocrinol 41:525–530

    CAS  Google Scholar 

  62. Smith MR, Goode M, Zietman AL et al (2004) Bicalutamide monotherapy versus leuprolide monotherapy for prostate cancer: effects on bone mineral density and body composition. J Clin Oncol 22:2546–2553

    Article  PubMed  CAS  Google Scholar 

  63. Diamond TH, Higano CS, Smith MR et al (2004) Osteoporosis in men with prostate carcinoma receiving androgen-deprivation therapy: recommendations for diagnosis and therapies. Cancer 100:892–899

    Article  PubMed  Google Scholar 

  64. Bilezikian JP (1999) Osteoporosis in men. J Clin Endocrinol Metab 84:3431–3434

    Article  PubMed  CAS  Google Scholar 

  65. Smith MR, Fallon MA, Lee H, Finkelstein JS (2004) Raloxifene to prevent gonadotropin-releasing hormone agonist-induced bone loss in men with prostate cancer: a randomized controlled trial. J Clin Endocrinol Metab 89:3841–3846

    Article  PubMed  CAS  Google Scholar 

  66. Taxel P, Fall PM, Albertsen PC et al (2002) The effect of micronized estradiol on bone turnover and calciotropic hormones in older men receiving hormonal suppression therapy for prostate cancer. J Clin Endocrinol Metab 87:4907–4913

    Article  PubMed  CAS  Google Scholar 

  67. Smith MR, McGovern FJ, Zietman AL et al (2001) Pamidronate to prevent bone loss during androgen-deprivation therapy for prostate cancer. N Engl J Med 345:948–955

    Article  PubMed  CAS  Google Scholar 

  68. Diamond TH, Winters J, Smith A et al (2001) The antiosteoporotic efficacy of intravenous pamidronate in men with prostate carcinoma receiving combined androgen blockade: a double blind, randomized, placebo-controlled crossover study. Cancer 92:1444–1450

    Article  PubMed  CAS  Google Scholar 

  69. Smith MR, Eastham J, Gleason DM et al (2003) Randomized controlled trial of zoledronic acid to prevent bone loss in men receiving androgen deprivation therapy for nonmetastatic prostate cancer. J Urol 169:2008–2012

    Article  PubMed  CAS  Google Scholar 

  70. Michaelson MD, Kaufman DS, Lee H et al (2007) Randomized controlled trial of annual zoledronic acid to prevent gondotropin-releasing hormone agonist-induced bone loss in men with prostate cancer. J Clin Oncol 25:1038–1042

    Article  PubMed  CAS  Google Scholar 

  71. Greenspan SL, Wagner JM, Nelson JB et al (2005) Alendronate prevents bone loss in men on androgen deprivation therapy for prostate cancer. J Bone Miner Res 20 (Suppl 1):S93 (Abstr F381)

    Google Scholar 

  72. Bruder JM, Ma JZ, Wing M et al (2006) Effects of alendronate on bone mineral density in men with prostate cancer treated with androgen deprivation therapy. J Clin Densitom 9:431–437

    Article  PubMed  Google Scholar 

  73. Body JJ (2001) Dosing regimens and main adverse events of bisphosphonates. Semin Oncol 28 (Suppl 11):49–53

    Article  PubMed  CAS  Google Scholar 

  74. Chang JT, Green L, Beitz J (2003) Renal failure with the use of zoledronic acid. N Engl J Med 349:1676–1679

    Article  PubMed  CAS  Google Scholar 

  75. Bamias A, Kastritis E, Bamia C et al (2005) Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: incidence and risk factors. J Clin Oncol 23:8580–8587

    Article  PubMed  Google Scholar 

  76. Woo SB, Hellstein JW, Kalmar JR (2006) Bisphosphonates and osteonecrosis of the jaws. Ann Intern Med 144:753–761

    PubMed  CAS  Google Scholar 

  77. Bilezikian JP (2006) Osteonecrosis of the jaw - Do bisphosphonates pose a risk? N Engl J Med 355:2278–2281

    Article  PubMed  CAS  Google Scholar 

  78. Black DM, Delmas PD, Eastell R et al (2007) Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med 356:1809–1822

    Article  PubMed  CAS  Google Scholar 

  79. Goss PE (2003) Emerging role of aromatase inhibitors in the adjuvant setting. Am J Clin Oncol 26:S27–S33

    Article  PubMed  Google Scholar 

  80. Kanis JA, Borgstrom F, De Laet C et al (2005) Assessment of fracture risk. Osteoporos Int 16:581–589

    Article  PubMed  Google Scholar 

  81. Guise TA (2006) Bone loss and fracture risk associated with cancer therapy. The Oncologist 11:1121–1131

    Article  PubMed  CAS  Google Scholar 

  82. Chien AJ, Goss PE (2006) Aromatase inhibitors and bone health in women with breast cancer. J Clin Oncol 24:5305–5312

    Article  PubMed  CAS  Google Scholar 

  83. Body JJ, Diel IJ, Lichinitser MR et al (2003) MF 4265 Study Group. Intravenous ibandronate reduces the incidence of skeletal complications in patients with breast cancer and bone metastases. Ann Oncol 14:1399–1405

    Article  PubMed  Google Scholar 

  84. Body JJ (2003) Zoledronic acid: an advance in tumour bone disease and a new hope for osteoporosis. Expert Opin Pharmacother 4:567–580

    Article  PubMed  CAS  Google Scholar 

  85. Srinivas S, Colocci N (2006) Bone related events in high risk prostate cancer. J Urol 176 (6 Pt 2):S50–S54

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, CHU Brugmann and Institute J. Bordet, Université Libre de Bruxelles ULB, 4 place van Gehuchten, Brussels, 1020, Belgium

    J. J. Body

  2. Department of Radioisotopes, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium

    P. Bergmann

  3. Leuven University Center for Metabolic Bone Disease & Division of Geriatric Medicine, Katholieke Universiteit Leuven, Leuven, Belgium

    S. Boonen

  4. Department of Rheumatology, Mont-Godinne University Hospital, Université Catholique de Louvain, Brussels, Belgium

    Y. Boutsen

  5. Department of Rheumatology, Université Catholique de Louvain, Brussels, Belgium

    J. P. Devogelaer

  6. Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium

    S. Goemaere & J. M. Kaufman

  7. WHO Collaborating Center for Public Health Aspects of Rheumatic Diseases, University of Liège, Liège, Belgium

    J. Y. Reginster

  8. Department of Obstetrics and Gynaecology, CHU St-Pierre, Université Libre de Bruxelles ULB, Brussels, Belgium

    S. Rozenberg

Authors
  1. J. J. Body
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Bergmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Boonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y. Boutsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. P. Devogelaer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Goemaere
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. Y. Reginster
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S. Rozenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J. M. Kaufman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to J. J. Body or J. Y. Reginster.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Body, J.J., Bergmann, P., Boonen, S. et al. Management of cancer treatment-induced bone loss in early breast and prostate cancer - a consensus paper of the Belgian Bone Club. Osteoporos Int 18, 1439–1450 (2007). https://doi.org/10.1007/s00198-007-0439-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-007-0439-4

Keywords

Search

Navigation