Oral Health in Breast Cancer Survivors on Aromatase Inhibitors

描述（由申请方提供）：芳香化酶抑制剂（AI）通常作为激素受体阳性乳腺癌绝经后女性的辅助激素治疗处方。芳香化酶抑制及其深刻的雌二醇（雌激素）消耗，与低骨密度和骨质疏松症的风险增加有关，骨折风险增加。AI及其导致的激素消融对乳腺癌女性口腔健康和口腔健康相关生活质量的潜在影响尚不明确。将在密歇根大学多学科环境中开展一个项目。一项横断面研究将用于评估150名接受辅助AI治疗的有早期乳腺癌病史的绝经后妇女和150名从密歇根州东南部密歇根大学卫生系统招募的无癌症绝经后妇女的口腔症状患病率。将进行全面的口腔检查（包括粘膜病变评估、牙周测量、龋齿、口腔X线检查、口腔液和牙齿脱落检查）。将对所有参与者进行评估社会人口统计学和行为因素以及生活质量信息的问卷调查。适当时，将使用逻辑回归模型分析关联的强度。该提案为琳达苏珊泰克曼博士在口腔健康领域的职业发展提供了一个全面的计划，因为它涉及辅助治疗和乳腺癌生存。短期目标是获得以患者为中心的研究中的临床研究专业知识技能，并获得内分泌治疗和口腔健康独立研究所需的辅助芳香酶抑制剂相关口腔效应的知识。长期目标是通过制定旨在改善乳腺癌幸存者健康和医疗保健的循证医生指南战略，加强医学教育和牙科之间的联系。教学培训和指导研究活动将为Taichman博士提供基础，使她能够在该奖项的最后几年提交极具竞争力的赠款申请，并开发未来的研究，以了解乳腺癌幸存者的最佳口腔护理。拟议的研究与NIDCR的使命的一部分有关，该使命涉及发展有关癌症治疗对口腔健康影响的基础知识。最终，这些信息可能会提高牙科健康专业人员和肿瘤学家预测和减轻AI治疗的口服毒性的能力。 公共卫生相关性：该项目将在芳香酶抑制剂的背景下探索口腔健康。一系列临床口腔健康评估，牙周生物标志物和口腔健康相关的生活质量数据将用于了解目前的治疗方式如何不仅影响癌症，而且影响口腔健康问题的发展风险。患者，牙科专业人员和医学肿瘤学家将受益于更好地了解乳腺癌幸存者的最佳口腔护理后续实践。

DESCRIPTION (provided by applicant): Aromatase inhibitors (AIs) are routinely prescribed as adjuvant hormonal therapy for postmenopausal women with hormone receptor positive breast cancer. Aromatase inhibition with its profound estradiol (estrogen) depletion, is associated with an increased risk of low bone mineral density and osteoporosis with increased fracture risk. The potential impact of AIs and their resulting hormone ablation on oral health and oral health related quality of life in women with breast cancer is undefined. A project will be conducted at University of Michigan in a multidisciplinary environment. A cross-sectional study will be used to assess the prevalence of oral symptoms among 150 post-menopausal women with a history of early stage breast cancer receiving adjuvant AI therapy and 150 postmenopausal women without cancer recruited from the University of Michigan Health System in Southeastern Michigan. Comprehensive oral examinations (including assessment of mucosal lesions, periodontal measures, dental caries, oral x-rays, oral fluid, and tooth loss examination will be performed). Questionnaires assessing socio-demographic and behavioral factors as well as quality of life information will be administered to all participants. Logistic regression modeling will be used to analyze the strengths of associations as appropriate. This proposal provides a comprehensive plan for the career development of Dr. Linda Susan Taichman in the area of oral health as it pertains to adjuvant therapy and breast cancer survivorship. Short-term goals are to acquire skills in clinical research expertise in patient centered studies and to gain knowledge of adjuvant aromatase inhibitor related oral effects necessary for independent investigations of endocrine therapies and oral health. Long-term goals are to strengthen the linkage between Medical education and Dentistry by developing evidence-based physician guideline strategies aimed at improving the health and healthcare of breast cancer survivors. The didactic training and mentored research activities will provide Dr. Taichman with the foundation from which she can submit highly competitive grant applications in the final years of the award and develop future studies to understand optimal oral care for breast cancer survivors. The proposed research is relevant to that part of NIDCR's mission that pertains to developing fundamental knowledge concerning oral health related effects of cancer therapies. Ultimately, this information may improve the dental health professional's and the oncologist's ability to anticipate and mitigate oral toxicities from AI therapy. PUBLIC HEALTH RELEVANCE: This project will explore oral health in the context of aromatase inhibitors. A constellation of clinical oral health assessments, periodontal biomarkers and oral health related quality of life data will be used for understanding how current therapeutic modalities impact not just the cancer, but the risk for development of oral health problems. Patients, dental professionals and medical oncologists will benefit from a greater understanding of the best oral care follow up practices of breast cancer survivors.