A Randomized Controlled Trial of Exercise to Prevent Bone Loss in Premenopausal Women with Breast Cancer

• Published in: Journal of women's health (Larchmont, N.Y. 2002) Vol. 28; no. 1; p. 87
• Main Authors: Tabatabai, Laila S, Bloom, Joan, Stewart, Susan, Sellmeyer, Deborah E
• Format: Journal Article
• Language: English
• Published: United States 01.01.2019
• Subjects: Absorptiometry, Photon; Adult; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Body Composition - physiology; Bone Density - physiology; Breast Neoplasms - complications; Breast Neoplasms - drug therapy; Cancer Survivors; Exercise; Exercise Therapy - methods; Female; Humans; Lumbar Vertebrae - physiopathology; Lumbosacral Region; Middle Aged; Osteoporosis - prevention & control; Premenopause; Resistance Training - methods; Tamoxifen - adverse effects; Tamoxifen - therapeutic use; Treatment Outcome; breast cancer; exercise; premenopausal; osteoporosis; bone loss; bone density
• ISSN: 1931-843X
• DOI: 10.1089/jwh.2017.6863

Background/Introduction/Objective: Premenopausal women treated for breast cancer are at high risk for bone loss. This trial examined the effects of a 1-year combined aerobic and resistance exercise program on bone mineral density (BMD) in women treated for premenopausal breast cancer. Premenopausal women (n = 206) age ≤ 55 years at cancer diagnosis who were within two years of receiving adjuvant chemotherapy were randomized to a 12-month exercise program or a control group. BMD was measured by dual-energy X-ray absorptiometry at baseline and after 1 year; blood was drawn for skeletal markers. Change from baseline to end of study was compared within and between treatment groups using paired and unpaired t-tests. Lumbar spine BMD declined in both treatment groups with no significant difference between treatment groups (-0.008 ± 0.003 g/cm exercise vs. -0.014 ± 0.003 g/cm control, p = 0.24). However, among the women who did not lose lean mass during the study (n = 100, 54 control, 46 exercise), the exercise intervention prevented lumbar spine bone loss (0.001 ± 0.005 g/cm treatment group vs. -0.014 ± 0.005 g/cm control group, p = 0.03). Bone turnover markers decreased significantly in both groups with no differences between groups. Among women who maintained lean mass, our exercise intervention prevented bone loss; however, our intervention did not prevent bone loss among women who lost muscle mass. Additional investigation into exercise regimens that can prevent both bone and muscle loss may help prevent long-term consequences of premenopausal breast cancer treatment.