Osteoporosis Prevention in Early Stage Breast Cancer

描述(申请人提供)：在美国，超过2人 数以百万计的女性患有乳腺癌。因为过去 化疗的进展，绝大多数女性被诊断为乳腺癌 癌症会存活很多年，但他们也会增加患癌症的风险 长期并发症与雌激素缺乏，淋巴清扫， 化疗对健康组织的其他影响证据表明 乳腺癌幸存者的女性患骨质疏松症的风险增加。这 绝经前妇女患绝经期疾病的风险最高 化疗。然而，关于骨丢失的程度存在争议， 只有少数几项研究评估了预防这种疾病的机制。双人间- 绝经前妇女每周服用阿仑磷酸钠的随机盲法对照试验 接受辅助化疗的乳腺癌患者将接受 定义并比较以下两种情况下骨密度和骨转换的变化 在乳腺癌的辅助化疗后。我们希望描述一下 化疗期间骨丢失的自然病史并确定危险因素 导致新诊断的绝经前乳腺癌的这种损失 病人。通过定义预测加速骨质流失的因素，我们希望 帮助指导预防性治疗。根据这项试验的结果，成本- 我们将模拟双膦酸盐治疗的效果。我们期待着 双膦酸盐将显著降低本病的骨丢失速度。 患者群体和双膦酸类药物用于预防 骨质疏松症及其相关并发症将具有成本效益。这个 该提案的培训部分包括与Karen博士的定期指导 Antman和Elizabeth Shane博士；与Alfred Neugut博士的广泛互动， Victor Grann博士和Richard Gralla博士；并继续在 哥伦比亚大学梅尔曼公共卫生学院。我作为一名 独立调查员将进行临床研究，以确定 癌症治疗方法将把毒性影响降至最低，防止长期- 长期并发症，并最大化生存、生活质量和成本- 有效性。

DESCRIPTION (provided by applicant): In the United States, more than 2 million women are living with a history of breast cancer. Because of past advances in chemotherapy, the vast majority of women diagnosed with breast cancer will survive for many years, but they will also have increased risk for long-term complications related to estrogen deficiency, lymph node dissection, and other effects of chemotherapy on health tissue Evidence suggests that women who survive breast cancer have an increased risk for osteoporosis. This risk is highest for premenopausal women who become menopausal with chemotherapy. However, controversy exists regarding the extent of bone loss, and only a few studies have evaluated mechanisms to prevent it. A double- blind randomized control trial of weekly alendronate in premenopausal women treated with adjuvant chemotherapy for breast cancer will be performed to define and compare the changes in BMD and bone turnover that occur during and after adjuvant chemotherapy for breast cancer. We expect to characterize the natural history of bone loss during chemotherapy and define risk factors that contribute to this loss in newly diagnosed premenopausal breast cancer patients. By defining factors that predict accelerated bone loss we hope to help guide preventive therapy. With the results of this trial, cost- effectiveness of bisphosphonate treatment will be modeled. We expect that bisphosphonates will significantly reduce the rate of bone loss in this patient population and that bisphosphonate use for the prevention of osteoporosis and its related complications will be cost-effective. The training portion of this proposal includes regular mentoring with Dr. Karen Antman and Dr. Elizabeth Shane; extensive interaction with Dr. Alfred Neugut, Dr. Victor Grann, and Dr. Richard Gralla; and continued formal coursework at the Mailman School of Public Health at Columbia University. My goal as an independent investigator is to conduct clinical research that will identify approaches to cancer treatment that will minimize toxic effects, prevent long- term complications, and maximize survival, quality of life, and cost- effectiveness.