Assessing falls and fractures in women receiving adjuvant aromatase inhibitors for early stage breast cancer

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 292-325-Breast & Prostate Cancer
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-308
Palak Choksi*1, Julia Stella2, David Hanauer3 and Catherine Van Poznak3
1University of Michigan, Ann Arbor, MI, 2University of Michigan Health Systems, Ann arbor, MI, 3University of Michigan Health Systems, Ann Arbor, MI

Aromatase inhibitors (AI) are routinely used in the management of postmenopausal women with hormone receptor positive breast cancer (BCA). Adjuvant AI use reduces the risk of BCA recurrence but are associated with an increased risk of fracture in women with early stage breast cancer (BCA). Falls are a major risk factor for developing fractures. This study retrospectively assessed the frequency of falls in women on adjuvant AI therapy.


After receiving approval from our medical school’s institutional review board, we used the University of Michigan Cancer Registry was used to identify women with BCA treated with an adjuvant AI between April 2002 and April 2012. Data were abstracted from electronic medical records using the record-query tool, EMERSE. Covariates included age, dates of adjuvant AI use, and report of falls and/or fractures captured from initiation of AI treatment to within 3 months of stopping AI.


The search identified 709 women (mean age 66) receiving adjuvant AI and 161 women (22.7%) had either fallen and/or fractured (152 falls + 9 fractures without documentation of fall) in the course of their AI therapy. Mean age for those who fell was 69 years and those who fractured was 67 years.  There were 70 patients (10%) who experienced at least one fracture. Forty nine women had more than one fall and 15 patients had more than one fracture. The wrist was the most common site of fracture. The average duration of AI use for those who fell was 43 months versus 31 months for those who did not fall.


In this chart review, falls occurred in approximately 21% of women on adjuvant AI. Those who fell had been on an AI for a longer duration (43 versus 31 months) than the group that did not fall. The retrospective nature of this study likely underestimates the prevalence of falls and fractures. This study design does not permit insights into the etiology of the falls. Prospective studies to investigate falls in postmenopausal women with breast cancer on adjuvant AI are planned.

Nothing to Disclose: PC, JS, DH, CV

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